[Histonet] Aetna and In-Office Lab Accreditation

Davide Costanzo pathlocums <@t> gmail.com
Tue Apr 10 11:13:16 CDT 2012

Very classy argument. Thank you for your eloquence.

Sent from my Windows Phone
From: Nicole Tatum
Sent: 4/10/2012 8:18 AM
To: Davide Costanzo; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] Aetna and In-Office Lab Accreditation
Really, An undertaker. Yea, theres definately a conflict here, you. No
since in wasting my time.


 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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