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How value-based care can generate lab revenue

July 24, 2019

Transitioning to value-based care  

With the shift of healthcare going from a traditional fee-for-service model to value-based system, the industry requires a completely different method for labs to help clients improve their quality of care, expedite their workflow, and maintain revenue.

Whether you manage a hospital, a commercial lab, or an outreach lab, it is important that you partner with a company that has the proven track record to help navigate in this new environment.

Sixty is the new forty

Statistics show that one in three American adults have multiple chronic conditions. On top of this, patients are living longer as life expectancy continues to increase.

By 2030, more than 20 percent of the population is expected to be over the age of 65, and this will place an increased burden on our healthcare system. As a result, a lab's workflow, efficiency, and value will become even more important when it comes to maintaining a successful business.

Reimbursements for value-based care

Previously, the fee-for-service payment system was based on volume. The more tests a lab ran ultimately translated to more revenue. There was little reason to optimize the value of tests, and unfortunately, more tests do not always equal improved health outcomes for the patient.

This old style of thinking can cause a cycle with ever-increasing costs and workloads that can fail the patients seeking treatment.

In 2015, the U.S. government created the Medicare Access and CHIP Reauthorization Act (MACRA) with the goal of moving aware from a fee-for service system to a value-based care system.

In the new system, Medicare calculates reimbursements and incentives based on data and metrics surrounding the overall health of patient populations, or based on individual episodes of care for a given patient rather than on the number of tests or services provided.

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Lab software integrates with MARCA/MIPS

CompuGroup Medical is here to help you incorporate a value-based system of healthcare.

Our lab management software fully interfaces to export all results needed for qualifying labs to take full advantage of MARCA and MIPS incentives.

Learn about CGM LABDAQ, CGM MEDICUS, or CGM SCHUYLAB for clinical testing and CGM AP EASY for anatomic pathology.

Contact us today to schedule a software demo.

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