Part A and Performance Incentives in the Era of COVID-19

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Robert Tessier, President and Panelist for the Panel of National Pathology Leaders and Senior Reimbursement Consultant for HBP Services, gave an online presentation on November 12, 2020 as part of The Dark Intelligence Group’s COVID-19 STAT Briefings. The topic, “Part A and Performance Incentives in the Era of COVID-19”, offered participants the chance to learn about opportunities to structure value-based Part A performance incentives in a hospital contract; understand how these arrangements are grouped by clinical and management deliverables and include specific calculations on how to quantify each result; and see how actual experience is used to put this new income in context with current Part A support. You can stream the presentation at this link.

Part A and Performance-Based Incentives

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On Tuesday, September 8, 2020, Robert Tessier, Senior Consultant at HBP Services and President of the Panel of National Pathology Leaders hosted the 2020 Executive War College’s first-ever “Virtual Meet-Up.” The topic of his talk was Part A and Performance-Based Incentives, during which he explained that performance-based incentives are a new concept for Pathologists and hospitals. He noted that generating “value” should be a significant component of hospital contracts and went on to explain how to implement an effective program to incentivize Pathologists using actual KPIs (key performance indicators), quality metrics and contractual examples.

Paycheck Protection Program (PPP)

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Robert Tessier, Senior Reimbursement Consultant for HBP, discusses updates to the Paycheck Protection Program (PPP) for Pathologists and Laboratories in the July 2020 edition of Laboratory Economics. SEE FULL ARTICLE HERE

HBP offers Financial Crisis Management Services

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The coronavirus pandemic has led to one of the worst fiscal crises in modern history. HBP has developed a series of recommendations for Pathologists to maximize revenue and minimize loss. Read more about our HBP Financial Crisis Management Services

Covid-19 Relief

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HBP’s senior reimbursement consultant, Robert H. Tessier, addresses the current COVID-19 health crisis in the April 20, 2020 issue of The Dark Report. To download the article, “Labs May Qualify for Relief Under New Federal Laws,” Click here

2018 HBP Pathologist Productivity Survey

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HBP recently released its 2018 HBP Pathologist Productivity Survey. Here are some highlights from the report:

    1. HBP’s  2018 Survey includes data for 478 full-time pathologists. This is more than twice the number included in our most recent 2016 survey.
    2. The number of groups increased from 17 groups in 2016 to 44 groups in 2018.
    3. The AVERAGE wRVUs per pathologist varied by less than 1% from 2016.
    4. The MEDIAN value per pathologist was 4% lower than 2016.

HBP would like to acknowledge the contributions of all the participants in this year’s survey, with a special thanks to Mick Raich and the staff of Vachette Pathology.

If you are interested in obtaining a copy of the full report, please contact Robert Tessier at rtessier@hbpworld.com.

 

Medicare’s 2017 Physician Utilization Database

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The Physician and Other Supplier Public Use File (PUF) provides information on services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals. The Physician and Other Supplier PUF contains information on utilization, payment (allowed amount and Medicare payment), and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and place of service. This PUF is based on information from CMS administrative claims data for Medicare beneficiaries enrolled in the fee-for-service program. The data in the PUF covers calendar year 2017. The interactive database can be found at:

 2017 Interactive Dataset: Medicare Physician and Other Supplier PUF

HBP also creates customized reports for pathology and other specialties based on the twenty-six fields of the database, including HCPCS code, state and place of service. Interested in what others in your city/state are charging? This information is available by procedure code.

Contact us for additional information.

VIEW SAMPLE REPORT  PAGES 

HBP Announces Panel of National Pathology Leaders (PNPL)

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PRESS RELEASE – Panel of National Pathology Leaders – June 2019 – FINAL

HBP Services, Inc., and McDonald Hopkins, LLC, are pleased to announce the formation of the Panel of National Pathology Leaders (PNPL), a national think tank dedicated to advancing best practices and creating value-based business solutions for Pathology groups. The group’s inaugural strategy session was held in Miami in March 2019, and a subsequent planning meeting took place in New Orleans at the end of April.

The mission of PNPL is to develop innovative strategies and solutions for the Pathology and lab medicine industry in response to operational and financial challenges, and to demonstrate value in an increasingly value-based healthcare delivery system. PNPL will work collaboratively with existing Pathology and laboratory associations on issues of common concern.

To learn more, please contact Allegra Klein at aklein@hbpworld.com

2019 Executive War College

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HBP’s Senior Reimbursement Consultant, Robert Tessier, participated in two sessions at the 2019 Executive War College in New Orleans:

  1. “Negotiating Win-Win Part A Pathology Contracts with Hospitals and Health Networks: Best Approaches to Adding At-Risk Incentives that Deliver Value, Establishing Commercially Reasonable Arrangements, and Determining Fair Market Value for Part A Services” – Presenter, May 1, 2019
  2. “Anatomic Pathology Groups and Their Labs: Effective Strategies for Maintaining Clinical Excellence and Financial Stability During Disruptive Times – Panelist, April 30, 2019

If you would like a copy of Bob’s presentation, please email info@hbpworld.com

“Value-based” Payments

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Healthcare in the U.S. is moving away from “fee-for-service” toward “value-based” payments. Pathologists now have the opportunity to define how provider systems can pay for the value that pathologists add. Pathology practices can also learn how to set prices for their groups using publicly available Medicare data.

HBP’s Senior Reimbursement Consultant, Robert Tessier, was recently interviewed for two articles on these topics which appeared in the Dark Report:

  1. Pathology Groups Should Act Now to Define Value – Dark Report Article 8-20-2018
  2. Medicare Data Makes Pathology Prices Public – Dark Report Article 10-22-2018

Click on the links above to view the articles, and email info@hbpworld.com if you would like customized pricing data for your geographical area.