WHAT IF?

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Anonymous

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According to many in the know and a lot of other sites here, these cuts will go through as planned and without reduction. That being the worst case scenario, what is the process or set of events to follow? Will we see staffing changes right away or will they come slowly? How will we know when the downsizing begins? It would be helpful to get real guidance. Encouragement is a great thing but only if it is warranted. Please don't say everything is going to be okay if you know it isn't.
 






Anonymous said:
According to many in the know and a lot of other sites here, these cuts will go through as planned and without reduction. That being the worst case scenario, what is the process or set of events to follow? Will we see staffing changes right away or will they come slowly? How will we know when the downsizing begins? It would be helpful to get real guidance. Encouragement is a great thing but only if it is warranted. Please don't say everything is going to be okay if you know it isn't.
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Major staffing cuts just before the sale goes through.

Cha Ching
 


















With November 1st less than a week away, I can only hope for the best. Sounds like CMS has issues with the new Affordable Care Act. I think the last thing on their mind is our situation. Therefore, I have to expect the cuts will go through.
 






LOL @ sale........sell what? The company was saved once due to Dr. H (much respect) and is too small and in the wrong segment. BTW - that goes for 90% of labs on here. Two big boxes and 5 or so will be left after these cuts IMO.
 






Anonymous said:
LOL @ sale........sell what? The company was saved once due to Dr. H (much respect) and is too small and in the wrong segment. BTW - that goes for 90% of labs on here. Two big boxes and 5 or so will be left after these cuts IMO.
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Good points. Do you think we will be one of those '5 or so' that will survive? Dr. H is a class act. He might be about ready to retire. If not, I'm sure he would be in demand anywhere.
 






Anonymous said:
LOL @ sale........sell what? The company was saved once due to Dr. H (much respect) and is too small and in the wrong segment. BTW - that goes for 90% of labs on here. Two big boxes and 5 or so will be left after these cuts IMO.
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Folks here seem to be zombies or they have had too much koolaid. Everyone I talk to says 'Ron says everything's going to be okay'. Really"
 






Anonymous said:
LOL @ sale........sell what? The company was saved once due to Dr. H (much respect) and is too small and in the wrong segment. BTW - that goes for 90% of labs on here. Two big boxes and 5 or so will be left after these cuts IMO.
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Ron says, "Don't worry, be happy." Looks like everyone believes this or else they have become zombie-fied.
 






This was on Clarient and Neo sites. Notice the hit FISH takes. No mention of Flow.

Re: FISH and flow 2014 cuts

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CAP is vigorously fighting the laboratory cuts in the medicare physician fee schedule for 2014.

According to the most recent CAP STATLINE report, CAP has admitted the proposed cuts to in-situ hybridization and immunohistochemistry are inevitable.

IMO Abbott, Quest, or LabCorp buys this company or it's lights out.

Just to emphasize the impact of these cuts, see below:

CPT code Description 2013 payment 2014 payment

88367 TC A Insitu hybridization auto $198.35 $40.30 (-80%)

88365 TC A Insitu hybridization (fish) $120.44 $40.30 (-67%)

88342 TC A Immunohistochemistry $73.15 $40.30 (-45%)


CMS to Finalize Proposed Physician Fee Schedule Rule by Nov. 27; CAP Expects Cuts to Some Key Pathology Codes; Other Key Payment Decisions

CAP expects the final 2014 rule to include cuts to the following pathology code families.

Immunohistochemistry – 88342 (PC & TC)
Enhanced Cytology Services – 88112 (PC & TC)
In situ Hybridization – 88365, 88367, and 88368 (PC & TC)

CMS also requested additional information on the payment level for 88305 TC. CMS reduced payment for 88305 TC by 52 percent last year. The College has provided additional information to CMS on the valuation of the technical component and has argued that the TC was reduced too steeply in 2013 and did not include some key input costs.

CMS has expanded its “misvalued code” initiative by targeting the top expenditure codes from each specialty as potentially overvalued, which triggered the review of the three additional code families.

As regular readers of this newsletter know, CAP has strongly opposed the CMS proposal to link payment for 39 pathology services to the Hospital Outpatient Rates and the additional proposal to “bundle” pathology and laboratory services into the Hospital Outpatient Payment Rates. Since July 8, 2013, CAP has vigorously advocated for the withdrawal of these policy proposals through multiple channels, including comment letters to CMS and member visits to Capitol Hill and the White House.

At the same time, the CAP has also been working through the AMA Relative Value Update Committee to mitigate the payment reductions to specific pathology services by ensuring that the revaluations of pathology services accurately account for the cost of delivering the service. Nevertheless, some reductions are inevitable, particularly to some services, which may not have been revalued for many years.

As the clock ticks down, and as we wait for publication of the proposed rule, CAP’s policy team will continue to keep members updated on any new developments.
 






Dude - quite bombing the board with your copy/paste - we all know cuts are coming.

But CSI, yes you are dead when H leaves. I know what accounts you have (mostly heme) and that will not get cut much as that happened years ago. They are attacking FISH which I do not get clinically, but I get they may want to shut down Tech Only. If CAP was smart they would bring in the pink ribbon as most HER2 is always confirmed via FISH and they have a large presence.
 






Anonymous said:
Dude - quite bombing the board with your copy/paste - we all know cuts are coming.

But CSI, yes you are dead when H leaves. I know what accounts you have (mostly heme) and that will not get cut much as that happened years ago. They are attacking FISH which I do not get clinically, but I get they may want to shut down Tech Only. If CAP was smart they would bring in the pink ribbon as most HER2 is always confirmed via FISH and they have a large presence.
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So is H really leaving? He could retire comfortably, but he doesn't seem like the kind.
 






I assume H may leave as he ages, not creating a rumor , just being pragmatic. Also, the value of Path staff has been diminished which sucks.

I was with Dr. H @ Impath and sold him all day, not his professionalism, just his expertise. He is a yeller/screamer but gave a diagnosis so Oncs could treat accordingly. Not many docs care who signs out cases as they just want result in a pretty report.

I assume he will accept a good job based on clinical trials but who knows.
Why I assume you will not be sold as one doc made CSI even a topic and why would he deal with more change.

I could be very wrong as well.
 






Anonymous said:
I assume H may leave as he ages, not creating a rumor , just being pragmatic. Also, the value of Path staff has been diminished which sucks.

I was with Dr. H @ Impath and sold him all day, not his professionalism, just his expertise. He is a yeller/screamer but gave a diagnosis so Oncs could treat accordingly. Not many docs care who signs out cases as they just want result in a pretty report.

I assume he will accept a good job based on clinical trials but who knows.
Why I assume you will not be sold as one doc made CSI even a topic and why would he deal with more change.

I could be very wrong as well.
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H.C.???
 






Anonymous said:
Dude - quite bombing the board with your copy/paste - we all know cuts are coming.

But CSI, yes you are dead when H leaves. I know what accounts you have (mostly heme) and that will not get cut much as that happened years ago. They are attacking FISH which I do not get clinically, but I get they may want to shut down Tech Only. If CAP was smart they would bring in the pink ribbon as most HER2 is always confirmed via FISH and they have a large presence.
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I don't think pushing the HER2 importance would help. There seems to be an attitude as far as medicare coverage, less is better. Seems they don't think it is financially wise to pay for draconian treatments for old folks. Stats show that it is during the last 2 years of life that the most is spent on medicare patients--phenomenal sums. Don't think there are death panels, but the notion that 'you've got to die of something sometime' is very much in vogue with CMS.
 






Anonymous said:
I don't think pushing the HER2 importance would help. There seems to be an attitude as far as medicare coverage, less is better. Seems they don't think it is financially wise to pay for draconian treatments for old folks. Stats show that it is during the last 2 years of life that the most is spent on medicare patients--phenomenal sums. Don't think there are death panels, but the notion that 'you've got to die of something sometime' is very much in vogue with CMS.
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Obamacare is window dressing. They hope to say all these people now have insurance. What they don't say is the premiums and deductible will be higher and services fewer.
Just heard a doctor saying as goes CMS, so goes most private insurance companies.
He says he gets $5 for an EKG. Says he and other docs will spend a lot less time with patients just to try to break even. Bottom line is that providers along with patients will bear the burdens of this 'affordable care act', while insurance companies and medicare skate.
 






























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