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To find patients at highest risk, hospitals combine consumer data with clinical information Dark Daily
Big data is all the rage in healthcare these days. However, one interesting development in this field is how hospitals are integrating consumer data with clinical data to identify patients at high risk. For example, if the post-surgical heart patient buys a package of cigarettes, some hospitals say they want to know. This is a trend with interesting implications for clinical laboratories.
A fast-growing medical lab tests anti-kickback law The Wall Street Journal
A fast-growing Virginia laboratory has collected hundreds of millions of dollars from Medicare while using a strategy that is now under regulatory scrutiny: It paid doctors who sent it patients' blood for testing. Health Diagnostic Laboratory Inc. transformed itself from a startup incorporated in late 2008 into a major lab with $383 million in 2013 revenues, 41 percent of that from Medicare.
Study: Many patients don't understand electronic lab results EHR Intelligence
More and more patients may be accessing their personal health information online through patient portals thanks to stage 2 of meaningful use, but only slightly more than half of patients, on average, were able to decipher electronic lab test results on their own, says a study from the University of Michigan. Patients who scored on the lower end of numerical and health literacy tests were twice as likely to express confusion when shown a hypothetical blood glucose test result, said study author Brian Zikmund-Fisher, associate professor of health behavior and health education at the U-M School of Public Health.
Study: 5 percent of patients in outpatient settings misdiagnosed, offering pathologists opportunity to provide more consultations to doctors Dark Daily
Publication of new peer-reviewed clinical studies indicates that, within the United States, more than 5 percent of outpatients, or 12 million people, are misdiagnosed annually. Few pathologists and clinical laboratory scientists would dispute this number because every day they see the best and the worst of how physicians use medical laboratory tests.
Gov. Scott: Fee reductions for healthcare professionals Florida Governor's Press Office
Governor Rick Scott announced fee reductions for the licensing of certain healthcare professionals. Due to efficiencies found and the streamlining of processes, both the Florida Board of Medicine and Florida Board of Nursing identified excess fees and are passing this on as a cost savings to licensees.
Will CMS exempt pathologists from meaningful use penalties? EHR Intelligence
Pathologists may be used to seeking out irregularities under the microscope, but with the support of Congress, they might also be staring at a relief from the financial penalties incurred by non-participation in the EHR Incentive Programs. With cuts to Medicare payments soon to begin for those who do not attest to meaningful use, the College of American Pathologists is arguing for an expansion of the hardship exemption to include immunity to future payment reductions in a letter to CMS Administrator Marilyn Tavenner.
OIG issues fraud alert for physician-lab relationships Jessica Belle
The Department of Health and Human Services Office of the Inspector General recently issued a special fraud alert that singles out the laboratory-referring physician relationship for its focused attention. The OIG has repeatedly emphasized that a lab providing free or below-market goods or services to a physician who is a source of referrals, or paying a physician more than fair market value for his or her services, could constitute illegal remuneration under the federal anti-kickback statute. In light of this special fraud alert, physicians and laboratories should review their compensation arrangements.
AACC highlights significant concerns with CLFS reimbursement plan AACC
The American Association for Clinical Chemistry is voicing significant concerns about the impact the Protecting Access to Medicare Act of 2014 may have on the Clinical Laboratory Fee Schedule. Readers will recall the House and Senate passed PAMA in late March, and among other things, it contained a Sustainable Growth Rate patch, a one year delay in the implementation of ICD-10, and a complete overhaul of how tests on the CLFS will be reimbursed beginning in 2017.
Palmetto GBA defining pathology Medicare fraud with new standards The Pathology Blawg
Palmetto GBA, the Medicare Administrative Contractor for Jursidiction 11 (the Carolinas and Virginias), is taking the rather extraordinary step of defining, using an evidence-based approach, the standards by which certain specimens should be pathologically evaluated. By doing this, Palmetto is placing itself at the forefront of combating Medicare fraud by pathologists and in-office laboratory owners.