[Histonet] Aetna and In-Office Lab Accreditation

Tue Apr 10 09:16:36 CDT 2012

Start with reading Dr. Schneider's post. Then read Richard Cartun's
post. Those should deal will what you are talking about very well.

These in-office labs should not exist, for the very same reason the
undertaker is no longer the ambulance driver. There is a very real, and
significant conflict of interest.

Sent from my Windows Phone
From: Nicole Tatum
Sent: 4/10/2012 6:45 AM
To: Davide Costanzo; histonet <@t> lists.utsouthwestern.edu
Subject: Re: [Histonet] Aetna and In-Office Lab Accreditation
Money is at the root of all finicial decisions, in-house labs and
hospitals. There are many over utilization of resources within the health
care field. Many gallbladder surgerious are performed unneccesarly by
general surgeous who's practice are within hospitals walls. Tonsilectomy.
etc. How are those specimens not self reffered to the hospitals AP lab.
David you made the comment about specialities staying with there specialty
and not branching out. A dermatopathologist specializes in derm specimens
so why is it so far fetched that he would read derm specimens from all
sources, hospitals or in-house labs. My in-house lab has a higher turn
around rate, lower overhead, and cuts courier fees out. We also do a
service to our patients by allowing them one stop shopping. We can service
all there needs and they do not have to have multiple appointments at
different facilities. This cuts down on their copay and billing from
multiple doctors. Also, it would cost more for a person to have Mohs
surgery in a hospital setting. As we all know cost are higher at a
hospital because they have higher overhead. The hospital is self reffering
when they let a surgery center or group be affiliated with them. The
surgery center was allowed to join the hospital so the hospital could reep
the revenue generated and process their specimens. Either way, we are all
joined by a common form of employment, and one facility is not better than
another. My field provides jobs and creates revenue just like yours.
Insurance company are going to make changes to try and make revenue during
this change into "OBAMA CARE". Remeber we are not the enemy they are. Who
are they to dictate how my company runs. Insurance companies have to much
power and the decisions they force us to make do not always provide the
best patient care. And that is the ultimate goal for any provider, to give
best patient care right? This is just another hurdle we all must jump
through in these comming changes. I vote we stick together and try our
best to protect all our jobs. Wasnt that long ago that each of us we
trying to get pay increases and bring the importance of our jobs to the
fore front of pathology. The financial squeeze of the helath care system
is going to be felt by all. Histology, pathology, radiology, cytology, we
all must do our best to role with the punches and ensure quality care and
our incomes, as well as our field, reguardless of location.

Nicole Tatum, HT ASCP

 Thank you for that. How are things at Hartford Hospital? One of my
> favorite
> places, rotated there many years ago. Very impressive facility! Is Dr.
> Ricci still there?
> On Mon, Apr 9, 2012 at 4:43 PM, Richard Cartun <Rcartun <@t> harthosp.org>
> wrote:
>
>> This was released today.
>>
>> Richard
>>
>> Statline Special Alert:
>> New Evidence Links Self-Referral Labs to Increased Utilization, Lower
>> Cancer Detection Rates
>> Study co-funded by CAP Appears in April 2012 Issue of Health Affairs
>> April 9—Self-referring urologists billed Medicare for nearly 75% more
>> anatomic pathology (AP) specimens compared to non self-referring
>> physicians, according to a study published today in a leading health
>> care policy journal. Furthermore, the study found no increase in cancer
>> detection for the patients of self-referring physicians-in fact, the
>> detection rate was 14% lower than that of non self-referring
>> physicians.
>>
>> These findings, from an independent study co-funded by the CAP, provide
>> the first clear evidence that self-referral of anatomic pathology
>> services leads to increased utilization, higher Medicare spending, and
>> lower rates of cancer detection. The study, led by renowned Georgetown
>> University health care economist Jean Mitchell, PhD, will appear in the
>> April 2012 issue of Health Affairs and is now available on the
>> journal’s website.
>>
>>
>> --------------------------------------------------------------------------------
>>
>>
>> >>> Daniel Schneider <dlschneider <@t> gmail.com> 4/9/2012 4:47 PM >>>
>> This is all about the money. The rest is rationalization.
>>
>> The reason a group of non-pathologist physicians opens an in-house
>> pathology lab and hires an employee pathologist is first and foremost
>> to harvest profit from pathology reimbursement. Be a fly on the wall in
>> the
>> partners' meetings and you would know that's what they are talking
>> about.
>>
>> To suggest otherwise is disingenuous.
>>
>> And the implication that the generalist anatomic pathologist is
>> unqualified
>> to be signing out skins, prostates, GI's and whatever is
>> reprehensible.
>> This is not cardiac bypass surgery, and AP pathologists *are* trained
>> to do
>> all of the above. I eagerly defer to subspecialty expert consultants
>> as
>> needed, but most of the time they're not needed.
>>
>> Hospital labs that see few, if any skins, prostates, GI's, are only in
>> that
>> pickle because of the cherrypicking they've already been subjected to.
>>
>> *"in-office AP labs are an emerging frontier of employment for
>> histologists
>> and pathologists.  In an era of high unemployment, another source of
>> employment for our professions is "a good thing.""*
>>
>> Really? The jobs follow the specimens. Given the same number of
>> specimens,
>> there's the same number of jobs, more or less, just under different
>> circumstances and in different locations   Unless you're suggesting
>> that
>> in-office labs will generate increased specimens, and thus increased
>> jobs
>> though overutilization, i.e. excessive numbers of unnecessary biopsies
>> and
>> abuse of the patient and the taxpayer.  In which case I have to say
>> there's
>> a grain of truth. And the truth hurts.  And it's not " a good thing."
>>
>> None of this should be taken as criticism of histotechs and
>> pathologists
>> who find themselves working in an in-office lab. I know there's bills
>> to
>> pay, families to take care of, and god knows it's hard for a
>> pathologist to
>> find a job these days with the numbers our residency programs keep
>> churning
>> out (but that's another rant...).
>>
>> Dan Schneider, MD
>> Amarillo, TX
>>
>>
>>
>>
>>
>>
>>
>>
>>
>>
>>
>>
>> On Mon, Apr 9, 2012 at 12:52 PM, <jdcochran <@t> aol.com> wrote:
>>
>> >
>> > Histonetters:
>> >
>> > In-office AP labs provide a valuable service to the practices they
>> serve
>> > by facilitating 1) better communication between pathologists and
>> ordering
>> > clinicians, 2) quality metrics that are practice-specific, and 3)
>> high
>> > volume, sub-specialization for both histotechnologists and
>> pathologists.
>> >  In other words, the more of one type of histopathology a lab does
>> (e.g.,
>> > skin, prostate, GI), the better it gets.  Most people would not think
>> of
>> > having their cardiac bypass surgery done at a community hospital
>> doing
>> > 50/year; you want to go where more than 500/year are done.  In
>> > histopathology, the kinds of volume you want are in the thousands for
>> each
>> > tissue type.  Many hospital labs do little skin or prostate
>> histology
>> > anymore.  Many sub-specialty in-office AP labs may do thousands of
>> cases of
>> > one tissue type every year.
>> >
>> > Aside from that, in-office AP labs are an emerging frontier of
>> employment
>> > for histologists and pathologists.  In an era of high unemployment,
>> another
>> > source of employment for our professions is "a good thing."
>> >
>> > This requirement by an insurer for accreditation will help to
>> validate
>> > these in-office AP labs' commitment to quality and put them on the
>> level
>> > with their hospital counterparts.
>> >
>> > John D. Cochran, MD, FCAP
>> >
>> >
>> >
>> >
>> >
>> > _______________________________________________
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>> > http://lists.utsouthwestern.edu/mailman/listinfo/histonet
>> >
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>
>
>
> --
> *David Costanzo, MHS, PA (ASCP)*
> Project Manager
> *Blufrog Path Lab Solutions*
> 9401 Wilshire Blvd. Ste 650
> Beverly Hills, CA 90212
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