Economics and changing reimbursements with health care reform. All of you operate within these confines and you probably ask yourself how can I maximize my money, especially with services I am already utilizing.
More than 30,000 other American College of Physicians members already operate their own clinical labs within their practices. It is estimated that, by sending your lab work out to a separate reference lab, you are throwing away approximately $120,000 per year. Important to recognize, though, is that you have to keep on top of the ever changing reimbursement rates that will change your revenue stream. Over the past decade, U.S. Health Care Reform has been driving significant change in the way care is organized, financed, and delivered. The mission of health care reform is to completely transform the current volume-based delivery model and change towards a value-based/evidence-based system. If you have previously tried to operate a clinical lab within your practice, you understand just how much the changing reimbursement rates can change your bottom line, making a once profitable endeavor into one that now loses your practice money. Choosing who you partner with can make all the difference and a goal of AMS is to make sure we form long lasting partnerships with our clients, ensuring that we keep on top of changing reimbursement rates and health care reform that might affect our partners.
Since the Balance Budget Act in 1997, Medicare and other insurers have been shifting money away from evaluation and management (E&M) while placing heavy emphasis on improving patient outcomes. Our mission statement is to ensure patients are receiving the best medical care by empowering physicians with high-quality, cost-efficient laboratory data to make more informed clinical decisions. Our goal is to establish a long-lasting, fruitful relationship with each client. We promise to deliver superior customer service and unparalleled expertise. This is absolutely where we excel above other companies, we will make sure whether your options are viable, especially over the long-term, and we will help advise you when they aren’t.
After going through the process of analysis and choosing which direction you would like to go with your lab, financing the equipment, finding staff, obtaining accreditations, installing and validating your equipment and assays (all of which we can help you do), you will see profit fairly quickly. In general, you should see, at minimum, a 16% increase to your revenue stream though this can be dependent upon payer and region you are located.
There may be some tests that you would still like to have performed that make sense to send out for analysis. This depends on your specific situation, the test, and reimbursement. We make sure to take all of this into account to make sure your lab and your clinic are profitable and, if it makes more economic sense, we will advise you towards that direction.
You will see an improvement in patient care. Commonly conducted tests include complete blood count, complete and basic metabolic profiles, hemoglobin A1C, pregnancy tests, T4 and T3, thyroid0-stimulating hormone, influenza, group A streptococcus, urinalysis, and microalbumin. Of course, there may be more tests available, but these are the common tests. Having an in-house lab is more efficient and can provide better results as it cuts down on variables involved with sample care when sending to an off-site lab.
Patient convenience: an in-office lab can eliminate having patients drive to a separate location for commonly required tests and test results will be available much quicker.
Time savings: while being able to provide testing results quickly, while patients are in your office, you will see a time savings for you and your staff in making treatment decisions and/or reducing follow-up telephone work to share results or schedule new appointments.
Disadvantages: Equipment can be expensive. Additional staff may be needed. Reimbursement rates change. There are space requirements for equipment. Accreditation beyond what your practice already has will probably be required. Therefore, it is very important to find the right partner that takes the financial stability of your practice into consideration.
If you have any questions, feel free to get in touch with your local CAC/representative or feel free to call us at 1-888-315-1519.