Vol. 18 • Issue 5 • Page 40
Professionals in nearly every industry are finding it increasingly necessary to seek out new means of income. Pathologists are no exceptions. They are, in fact, being forced to assess their own practices and explore new options. Fortunately, profitable avenues do exist.
Collaboration as a Source of Revenue
The evolution of healthcare is reflected in the changing face of pathology, and as it continues to evolve, so too will pathology revenue. Pathologists must keep an eye to the future and be prepared for changes. For example, a more collaborative effort between pathology and radiology departments is being forecasted by some experts. Such a collaboration (some go so far as to call it an integration) will certainly have an impact, asserts Ossama Tawfik, MD, PhD, professor, vice chairman for Education and Outreach, and director of Anatomic and Surgical Pathology in the Department of Pathology and Lab Medicine at The University of Kansas Medical Center, but it's impossible to know exactly how and when that future will unfold.
"We're going to have more integration between disciplines in an unprecedented way," he says. In fact, radiologists and pathologists at Dr. Tawfik's facility are already collaborating on breast cancer reports, and he speculates that there will be a redistribution of revenue in the future. "The impact of collaboration is going to be tremendous" in how we care for patients, he continues.
He also predicts a possible shift to "super specialists" born of these efforts in areas like prostate biopsies or breast pathology, for example, who will be ordering more tests based on their in-depth expertise.
The bottom line is optimizing patient care, Dr. Tawfik asserts. The more experienced or knowledgeable someone is about a certain area of diagnoses, the better care the patient can expect. And when a decision is made by a team of experts instead of one person, the credibility and confidence in the diagnosis and treatment of every individual patient increases.
Outreach Revenue
Implementing or increasing an outreach business remains an often-cited strategy for upping profitability. For some hospital labs, it can be the difference in becoming a profit versus a cost center, explains Donna Beasley, DLM(ASCP), channel manager, Laboratory Outsourced Billing, McKesson Revenue Management Solutions. The challenge, of course, is in finding business when many labs already have established relationships with their outreach providers and there is industry- and nationwide belt-tightening.
Determine whether your lab has the resources to take on more testing or if profitability would still be possible if additional equipment or employees would be required. If you don't operate at full capacity, taking on a small outreach business can be a fairly easy task that offers quick profit. Adding a small selection of molecular tests that are run on one platform can be a reasonable approach.
Set small, manageable goals to increase your likelihood for success; setting lofty goals and failing may only serve to frustrate. For a pathology lab already performing outreach testing, incrementally expanding services is an easier undertaking than starting out, since systems and processes are already in place.
A clear vision and a commitment from the team are both necessary for making an outreach business successful, Dr. Tawfik states. It's a long and difficult process, he warns, and when you take on customers, "you have to take care of them consistently. You have to make sure you have the infrastructure and resources to provide continuous, sustained services."
Dr. Tawfik also stresses the importance of knowing your strengths and focusing on a particular specialty. It's hard to be the best at everything, but if the lab has a special expertise in dermatopathology or breast pathology, for example, target those customers in your outreach business.
Beasley also suggests outsourcing the complete billing management as a way to improve efficiency, get control of revenue and optimize reimbursement. Outreach labs that prefer to do their billing internally should utilize a billing system built specifically for labs that allows them to manage their clients-offering multiple fee schedules and discounting and specific formatting of invoices. Whether using an in-house or outsourced system, you should be able to "house cost information down to the test level, so that pathologists not only see revenues but are able to marry those revenues with costs to see true profitability by procedure, client, sales representative or territory. The IT system utilized to do the billing is key to the success of an outreach lab's fiscal viability," Beasley states.
Bridging the Digital Divide
Digital pathology is becoming increasingly accessible for the average lab. And as its use becomes more widespread, labs will see an array of workflow and cost benefits. Outreach testing will be enhanced or complemented by remote analysis.
Dr. Tawfik reiterates the sentiment that digital pathology is not a one-size-fits-all solution; its implementation should depend on each lab's needs and available technology. That said, he believes the impact will be significant, especially for pathologists and patients in a remote or rural area in need of special expertise. "That gives a patient tremendous confidence in the treatment," Dr. Tawfik notes.
We're seeing larger pathology groups now supplying sub-specialty expertise in areas like hematopathology and neuropathology to smaller groups through digital pathology, says Joseph R. Stabile, MT(ASCP), product marketing manager, Horizon Laboratory Solutions. "As costs for these systems come down rapidly and quality goes up, average-size groups serving multiple locations can now use digital pathology for consults, both within and outside of their group," says Stabile. Digital access to such specialists means cost savings on courier services and quicker information for physicians.
Know Your Stuff
While reimbursement levels seem to steadily decrease, understanding denials can be a powerful tool in overcoming regular denials. Billing staff should have a clear understanding of claims processing rules, coding and documentation. Assess the frequency with which any particular code or test is being denied and analyze the reasons. Study your options and seek, for example, another method for performing the particular analysis, or a better way of coding it.
In some cases, says Beasley, pathologists don't know what the costs are and what the revenue is, andthere may be some tests that shouldn't even be performed. "You have to have this information to make wise, strategic decisions," she insists. Understanding your clients and their statistics is important. Having the management reports to proactively make decisions will have a large impact on success. An outreach lab might be giving a client a case of purple-top tubes every month, she offers as an example, but only sending in 50 CBCs. It's vital to monitor the output of supplies by having utilization reports as well as client compliance statistic reports.
Although more work and a harder search might be necessary to find new revenue sources, there are steps pathologists can take to reveal greater profitability and maintain high quality operations despite economic challenges.
Kelly J. Graham is assistant editor.
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