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Anonymous

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GI Path is in a world of trouble. 88305 will destroy our company and the Derm line.
My clients are out of network with many plans and out managed care dept sucks. I am sure layoffs are coming even though many friends of mine quit recently.
 


Anonymous said:
GI Path is in a world of trouble. 88305 will destroy our company and the Derm line.
My clients are out of network with many plans and out managed care dept sucks. I am sure layoffs are coming even though many friends of mine quit recently.
Click to expand...

the storm is just under way.....Gipp will go down faster than a 3 dollar hooker
 


also...big problem with pathologist's skill sets...two many silos...one group path only sing gi...one group only sign GYN, etc...you think that someone who has signed out only gi biopsies for >5 years will be able to sign out other cases once the single speciality reimbursement dries up? look for pathologist numbers be markedily reduced as the company contracts...i highly doubt anyone will work for 1/2 their current salary...so either they'll leave or have to be terminated...would have much better to have pathologist that can signout anything...with the exception of heme...diversity is the key when reimbursemenrts are drying up

what about the reimbursement limitations/exclusion that managed care is not placing on biopsies read out of state? (BCBS is latest example)....

what about the major carriers getting onlione to be the proxy facilitators of the ACA mandated state exchanges? what role would their be for a free standing coporate lab once the bundled value payments come on line trhough ACO or equivalent care delivery model? once hospital systems have the majority control of the "lives" in the regional health care systems?

unless there is a radical change in the business construct, the future is not good.
 


Anonymous said:
also...big problem with pathologist's skill sets...two many silos...one group path only sing gi...one group only sign GYN, etc...you think that someone who has signed out only gi biopsies for >5 years will be able to sign out other cases once the single speciality reimbursement dries up? look for pathologist numbers be markedily reduced as the company contracts...i highly doubt anyone will work for 1/2 their current salary...so either they'll leave or have to be terminated...would have much better to have pathologist that can signout anything...with the exception of heme...diversity is the key when reimbursemenrts are drying up

what about the reimbursement limitations/exclusion that managed care is not placing on biopsies read out of state? (BCBS is latest example)....

what about the major carriers getting onlione to be the proxy facilitators of the ACA mandated state exchanges? what role would their be for a free standing coporate lab once the bundled value payments come on line trhough ACO or equivalent care delivery model? once hospital systems have the majority control of the "lives" in the regional health care systems?

unless there is a radical change in the business construct, the future is not good.
Click to expand...

You sound like you know what you're talking about, and since I am not a billing person, maybe you can answer this. With the lowered reimbursements for just about every test under the sun, what would be the consequences from medicaid, medicare and private insurers, if the company tried to increase compensation by adding glitz to testing that would be medically unnecessary? That strategy is definitely in the wind. Will the insurers demand that the added on 'complexity' be justified before paying?
 


...glitz doesnt matter. In about 10 years there will be a two tier health system...one being feds...the other being botique shops that you pay cash to get timely medicine...this is european style medicine...the feds will say what is,paid for...medicare and insurance will exist in name only...the insurance companies will be paid by feds to facilitate healthcare...they wont have say over what is,covered...thats the feds...the fifteen panel commision...brave new world....so it wojt matter how you matket or package testing, if feds wont pay or if peopke wont pay cash...it aint going to matter
 


Anonymous said:
You sound like you know what you're talking about, and since I am not a billing person, maybe you can answer this. With the lowered reimbursements for just about every test under the sun, what would be the consequences from medicaid, medicare and private insurers, if the company tried to increase compensation by adding glitz to testing that would be medically unnecessary? That strategy is definitely in the wind. Will the insurers demand that the added on 'complexity' be justified before paying?
Click to expand...

This person does not know that they are talking about. Adding on medically unnecessary testing to biopsies has been tried before. Bostwick's gynecor division performed $2500 endometrial biopsies. BioReference and Aureon performed $2200 Pap smears. Patients and insurers were outraged. Even greedy doctors got sick of patient complaints. Adding on expensive molecular tests to routine biopsies (for which code stacking is no longer allowed. Every molecular test has a unique CPT code now listed on the CMS clinical laboratory fee schedule, gap filled for 2013). This strategy will fail. Not only is it unethical, but unnecessary testing is a form of healthcare fraud. Go with it if you look good in stripes or in an orange jumpsuit. You can do a MALT-1 break-apart FISH probe on every gastric biopsy with inflammatory cells, or maybe do PCR for CMV and Herpes in every esophageal biopsy with a single inflammatory cell. If I were at GI path in Memphis I would leave. The business model was tenuous before the 52% cut in the TC for 88305. Now, it's DOA.
 


Yeah...I am out of here after my new start date begins in March. Writing is on the wall. C' ya later. Owners are probably chompin' at the bit to figure out a way to get out of this mess of a business model. Hmmmm...let's not do histo or let our clients do client bill and then take the smallest of margins and see how long we survive. DUHHHH! Goin' down!
 




sure...until the IHC and histochemical stains get cut for the 2014 PFS...then all the "panels" that are ordered will have less margins with same overhead..
also, molecular codes are now in the CLFS and not PFS going forward...sooooo...there will be no money in tacking on molecular testing...
best of luck
 




Rumor has it the pathologists will be working for free soon....best of luck with no path around to signout cases...once you start nickling and diming payroll, the decline has begun
 








maybe the pathologists there should work for free...no benefits...no salary...no reimbursements for CME...nothing...just for the pleasure of working at such an esteemed lab...what is so wrong with that idea?...better yet...pay PHC to work there....yes!
 




not yet...but its coming....no bonus...no 401K...nothing...oh...renegotiated low low salary...where you going to go?....same issues will all coporate labs....even worse if you have only signed out one type of path for years...you aint going anywhere...PHC knows that and have you all by the short hairs....have fun in fancy new building making less than the sales people...you all having to buy your own office funiture? blawahhhahhaaa
 


Sales people are not making money anymore! In fact the gates are open and many of them are starting to leave. You can't continue to treat your people the way you do! Company is a mess and falling apart.
 







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