Full presentation by Dr. Philip Chen delivered to healthcare and laboratory medicine leaders at theĀ Roche Efficiency Days (RED) 2018: REDefining perspectives in Guangzhou, China regarding Pathology Data Analytics.
The US Healthcare delivery system is rapidly shifting from volume-based fee-for-service arrangementĀ to one that focuses on value and patient outcome. The goals are to improve patient care and reduceĀ healthcare expenditure on the population basis. Patient outcome is measured by specific ClinicalĀ Quality Measures (CQMās). In the value-based environment financial incentives are provided forĀ better patient outcome while fee schedule reductions are deployed to remove incentives for inappropriateĀ and unnecessary use of healthcare resources. Clinical laboratory data can provide valuable actionableĀ information.
However, in order to receive value-based incentives, laboratories must be able toĀ demonstrate direct impact on improved clinical and financial outcome in care delivery. At this session,Ā how to perform integrated clinical and health insurance claims analysis to identify high value interventionĀ strategies will be reviewed. Experiences in establishing novel informatics services by clinical laboratoriesĀ to provide direct population health management in a community setting will be shared. EstablishingĀ financial values for these unconventional laboratory services and how to use them to negotiate forĀ value- and outcome-based reimbursement will be discussed.
