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At least 19 recordsLinked to original sources
PubMed1998

Medicare's demonstration of competitive bidding for clinical laboratory services: what it means for clinical laboratories.

The purpose of Medicare's Demonstration of Competitive Bidding for Clinical Laboratory Services is to determine whether competitive bidding can be used to provide quality laboratory services at prices below current Medicare reimbursement rates. Here, we present key features of the preliminary design for the demonstration. The following areas are covered: scope of the demonstration, bidding process, selection of winners, reimbursement, quality, and administration and monitoring. The role of the Health Care Financing Administration's Laboratory Technical Advisory Committee is also described, and the future of competitive bidding in a Medicare managed care environment is evaluated. We close with some brief comments on how to succeed in competitive bidding for Medicare services.

Centers for Medicare and Medicaid Services, U.S.↗
PubMedDate not supplied

Regulation in review. Payment reform likely to continue for clinical laboratory services.

Payment for clinical laboratory services has been at the forefront of Medicare payment reform. Significant changes are likely to continue. These changes may eliminate the well-established practice of selling laboratory services to physicians at discount prices and may require laboratories to compete for the opportunity to participate in managed-care arrangements that result from federal health-care reform. Laboratories should restructure, as necessary, to ensure that they can provide testing at the lowest possible cost and to otherwise prepare for health policy changes.

Clinical Laboratory Techniques↗
PubMed2006

Hospital nursing satisfaction with clinical laboratory services: a College of American Pathologists Q-Probes study of 162 institutions.

CONTEXT: Monitoring customer satisfaction is an important and useful quality improvement tool and is required of most clinical laboratories in the United States. OBJECTIVE: To survey the level of nursing satisfaction with hospital clinical laboratory services. DESIGN: Participating laboratories provided information regarding laboratory demographics and practices. These laboratories then surveyed hospital nursing personnel regarding their level of satisfaction with defined aspects of laboratory service. SETTING: College of American Pathologists Q-Probes laboratory quality improvement study in 162 hospital laboratories. MAIN OUTCOME MEASURES: Nursing overall satisfaction score (ranging from 1, not satisfied, to 5, very satisfied) and satisfaction scores for 13 specific aspects of clinical laboratory services. RESULTS: One hundred sixty-two institutions submitted data from a total of 7033 nursing surveys. The overall satisfaction score for all institutions ranged from 2.5 to 4.6. The median overall score for all participants was 3.9 (10th percentile, 3.2; 90th percentile, 4.2). Nursing personnel were most satisfied with the accuracy of test results, phlebotomy courtesy toward patients and nursing staff, and notification of abnormal results. They were least satisfied with stat test turnaround time, laboratory management responsiveness and accessibility, phlebotomy responsiveness to service requests, and routine test turnaround time. The most important aspect of laboratory service reported by nursing personnel was stat test turnaround time. CONCLUSIONS: Most nursing personnel are satisfied with the clinical laboratory services that are provided to the patients in their care. Although test result accuracy is very highly regarded, there is room for improvement in several aspects of service, particularly in test turnaround time and laboratory management accessibility and responsiveness.

Clinical Laboratory Techniques↗
PubMed1986

Medicare outpatient clinical laboratory services payments: relative value scale approach.

The Health Care Financing Administration is in the process of designing a competitive bidding model for the purchase of outpatient clinical laboratory services. One segment of this process involves the development of a relative value scale (RVS). The RVS could be used as part of the bidding process and as the basis of payment. The RVS could also be used as the basis of a national fee schedule, as stipulated in the Deficit Reduction Act of 1984. Potential problems with the development of an RVS from local (carrier) fee schedules for outpatient clinical laboratory services were investigated.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1994

OpenLabs: the application of advanced informatics and telematics for optimization of clinical laboratory services.

OpenLabs has four major objectives: to improve the efficiency and effectiveness of clinical laboratory services by the integration of Knowledge Based Systems (KBSs) with Laboratory Information Systems (LISs) and equipment; to provide and implement standard solutions for Electronic Data Interchange (EDI) between laboratories and other medical systems; to specify a fully Open architecture for an integrated Clinical LIS and demonstrate the integration of various KBS modules on the open architecture platform; and to demonstrate the integration of OpenLabs modules with existing LISs.

Clinical Laboratory Information Systems↗
PubMed1993

Hamilton Health Sciences Laboratory Program: a provider developed model for hospital, university and community laboratory services.

Clinical Laboratory Sciences are under pressure to reduce the number of tests and cut staff and supply costs. The ability of academic centres to continue to deliver high quality service, teaching and research is threatened. In difficult economic times imaginative strategies are needed to look for solutions which will permit continued advancement in academic and clinical standards. Rationalization of service and cost-effective use of resources are not new concepts; however, there is a scarcity of models which have been developed and promoted by the providers of laboratory services, rather than those imposed by governments and other paying agencies. A model developed and evolved over the last two decades by The Hamilton Health Sciences Laboratory Program (HHSLP) is outlined.

Data Collection↗
PubMed1995

Medicare program; physician financial relationships with, and referrals to, health care entities that furnish clinical laboratory services and financial relationship reporting requirements--HCFA. Final rule with comment period.

This final rule with comment period provides that, if a physician or a member of a physician's immediate family has a financial relationship with an entity, the physician may not make referrals to the entity for the furnishing of clinical laboratory services under the Medicare program, except under specified circumstances. It contains revisions to our proposal of March 11, 1992, based on comments submitted by the public. Further, it incorporates the new expansions and exceptions created by the Omnibus Budget Reconciliation Act of 1993 and the amendments in the Social Security Act Amendments of 1994 (SSA '94), that are related to referrals for clinical laboratory services and have a retroactive effective date of January 1, 1992. In addition, we are responding to comments received on the interim final rule with comment period (published on December 3, 1991) that set forth Medicare reporting requirements for the submission by certain health care entities of information about their relationships with physicians. That document implemented the reporting requirements of section 1877(f) of the Social Security Act. This rule revises those requirements to incorporate the amendments to section 1877(f) made by SSA '94, to apply to any further reporting we may require.

Budgets↗
PubMed1996

Delivering clinical laboratory services to intensive care units.

In response to the pressures of cost reduction, we established and evaluated a carefully integrated program to deliver clinical laboratory services more promptly and efficiently to the intensive care units (ICUs). The new protocol reduced the steps and turnaround time from ordering tests by physicians to reporting results by as much as 80% on all ICUs, permitting significant reductions in personnel (exceeding $400,000 per year). For the surgical ICU there were also fewer blood collections (mean preprotocol: 7.0 per patient per 24 h; mean last 12 months: 6.0; P= 0.002). The volume of blood collected fell from 8.1 to 3.5 mL per collection, primarily following an emphasis on small containers. Consequently, the amount of blood taken from each surgical ICU patient decreased from 56 to 21 mL per 24 h (P <0.001).

Blood Specimen Collection↗
PubMedDate not supplied

Mystery patient insight into clinical laboratory service.

Gone are the days when most patients tolerated impersonal service from their physicians and health-care providers in general. Every day, customer and patient satisfaction becomes more critical to a health-care provider's success and survival. Open communications, Internet-informed patients, and aggressive watch groups reveal those health-care providers who consistently deliver poor service. Most health-care providers employ patient satisfaction surveys to monitor their level of service; however, written and telephone surveys seldom provide the surveyor the insight necessary to provide differentiating service because of a large illiteracy rate and fear of reprisal. Toward this end, a well-trained mystery patients offers the health-care provider greater insight into how service is dispensed to its customers and patients. This article offers an aggregate of mystery patient insights into delivering clinical laboratory services both in hospital and medical practice environments, supported with insightful information into creating winning service strategies.

Benchmarking↗
PubMed1981

Medicare and Medicaid programs; reimbursement for clinical laboratory services: Health Care Financing Administration. Final rule with comment period.

These regulations implement section 918 of Public Law 96-499, the Omnibus Reconciliation Act of 1980, which establishes the payment criteria for laboratory services billed by physicians under the Medicare and Medicaid programs. Specifically, these amendments provide that: (1) laboratory tests performed by a physician, or personnel under his or her supervision, will be paid on the basis of the reasonable charge for the service (determined under the usual Medicare rules on reasonable charges); (2) laboratory tests performed by an independent laboratory, but billed by a physician who identifies the laboratory and the amount the laboratory charged him or her, will be paid on the basis of the lesser of (a) the laboratory's reasonable charge for the service, or (b) the amount the laboratory charged the physician for the service; and (3) if the physician does not identify the laboratory and the amount it charged him or her for the test, payment will be based on the lowest amount at which the Medicare carrier estimates the test could have been obtained by the physician from a laboratory serving the physician's locality. These rules should result in lower Medicare and Medicaid payments since they limit recognition of markups of bills from physicians for services performed by independent clinical laboratories and enable the programs to benefit from discontinued rates obtained by physicians.

Hospitals↗
PubMed1996

Medicaid Program; Medicaid eligibility quality control, progressive reductions in federal financial participation for FYs 1982-84, payment for physician billing for clinical laboratory services, and utilization control of skilled nursing facility services: removal of obsolete requirements--HCFA. Final rule.

This final rule removes several obsolete sections of the Medicaid regulations that specify rules and procedures for disallowing Federal financial participation for erroneous medical assistance payments due to eligibility and beneficiary liability errors as detected through the Medicaid eligibility quality control program for assessment periods from 1980 through June 1990. The Medicaid regulations that contain the rules and procedures for the progressive reductions in Federal financial participation in medical assistance expenditures made to the States for fiscal years 1982 through 1984 are removed to reflect the repeal of the statutory bases for the reductions. The Medicaid regulations that provide for physician billing for clinical laboratory services that a physician bills or pays for but did not personally perform or supervise are removed to reflect the statutory repeal of this provision. In addition, the rule removes obsolete regulations that prescribe requirements concerning utilization control of Medicaid services furnished in skilled nursing facilities. This rule is part of the Department's initiate to reinvent health care regulations and eliminate obsolete requirements.

Centers for Medicare and Medicaid Services, U.S.↗
PubMedDate not supplied

Accreditation Manual for Pathology and Clinical Laboratory Services. Joint Commission on Accreditation of Healthcare Organizations.

Scoring guidelines (specifically the intent statements) for selected laboratory standards have been revised. The changes become effective for surveys conducted after January 1, 1995. Additions are indicated below by underlining, and deletions are shown by strikeout. [These revised scoring guidelines are printed on perforated pages for easy removal and insertion in the Accreditation Manual for Pathology and Clinical Laboratory Services (LSM)]

Accreditation↗