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ADVANCE Discourse: Lab

Final ACO Rule More Feasible for Pathologists, Clinical Labs

Published November 11, 2011 7:30 AM by Jill Hoffman

The U.S. Department of Health and Human Services (HHS) has released the final regulations implementing accountable care organizations (ACOs) and the Shared Savings programs. Numerous changes to the regulations appear to make them more feasible for pathologists and clinical labs.

 

In particular, the American Society for Clinical Pathology (ASCP) hopes the elimination of the proposed meaningful use requirement making electronic health records (EHRs) necessary for participation may provide some relief for pathology groups and smaller clinical labs hoping to participate.

 

Though the rule will not guarantee that pathologists are eligible to participate (the decision is up to each ACO), the final rule does not prevent their participation in or receiving shared savings. In comments on the proposed rule, the ASCP highlighted the important role that pathologists could and should play in ACO goals toward cost containment, quality improvement and enhanced patient experience.

 

As part of its response to hundreds of comments received, the HHS cut in half the number of quality measures on which ACOs would have to report from 65 to 33. The HHS also increased the financial incentives for organizations to participate. Many groups representing physicians, clinics and hospitals had warned HHS that they would not take part in the proposed payment system reform without significant changes.

 

The proposed meaningful use requirement rule had suggested that at least 50% of primary care providers must be “meaningful users” of EHRs. The requirement could have proven problematic for the lab industry, as the EHR meaningful use rule could have helped clinicians get labs to pay for the costs of interfacing the lab to the clinician’s EHR (estimated to range in cost from $5,000 to $15,000 per interface). The ASCP had argued that adoption of EHR meaningful use metrics could negatively affect pathologists and lab medicine professionals, who will likely be responsible for the bulk of patients’ medical records.

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