Helping Hospitals Deliver Enhanced Patient Care with Superior Diagnostic Testing Solutions

In 2018, roughly 53% of clinical tests in the United States were produced in a hospital setting.

Hospital Clinical Laboratory

In recent years, the health care system has witnessed a shift from a Fee-for-Service (FSS) model, to a Valued-Based model. Under a Valued-Based model, hospitals are paid and incentivized based on the health outcome of their patients, instead of the services they provide. Table 1 compares the traditional FFS model vs. the more modern Valued-Based model. As Valued-Based healthcare policies continue to expand, hospitals will need to move towards an enhanced patient management model. Since clinical laboratories analyze and generate patient test results, they are a vital factor in this shift. The laboratory decision makers will need to implement strategies to enhance their laboratory’s productivity, along with the quality of their patient’s test results, for an overall improved diagnosis. HORIBA Medical’s comprehensive portfolio of diagnostic products and services, assists several hospital clinical laboratories with key initiatives, ranging from procurement consolidation and profitability growth, to most importantly, delivering enhanced patient care.

Million - the number of visits to a Hospital’s emergency department in 2018*

Million - number of emergency department visits resulting in hospital admission in 2018*

%

The Percent of visits with patient seen in fewer than 15 minutes in 2018*

Table 1: Fee-for-Service model vs. Valued-Based model

Fee-for-Service

Valued-Based Health Care

Reimbursed by third party payers such as insurance companies & Government agencies (Medicare or Medicaid)
Reimbursed by third party payers such as insurance companies & Government agencies (Medicare or Medicaid)
Incentivizes higher paying services
Incentivizes services best for the patient
Billing and payments are determined by the number of visits and tests they order
Billing and payments are determined based on the outcome achieved through medical care
Payments based on the services performed
Payments based on success of the procedures
Time spent in in-patient facilities is not a primary factor
Emphasis on reduced time spent in in-patient facilities

 

References:

* “FastStats – Emergency Department Visits.” Edited by CDC/National Center for Health Statistics, Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 9 Apr. 2021, www.cdc.gov/nchs/fastats/emergency-department.htm.

**Pizzo, James J., and Todd Fitz. “Are your physician-integration strategies sustainable? Hospitals and health systems require sustainable strategies for integrating with physicians if they are to achieve continued success in the nation’s future valued-based healthcare delivery system.” Healthcare Financial Management, Nov. 2012, p. 66+. Gale Academic Onefile, Accessed 14 Oct. 2019.

***Hodgin, Scott. “Value-Based Care vs Fee-for-Service.” Insight TXCIN, 2018, http://www.insight-txcin.org/post/value-based-care-vs-fee-for-service.

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