How does pathology fit into ACOs and in the new model of healthcare delivery?

[pathstudent]

One thing I find confusing is you often hear about how the new model for medical care will base reimbursement on the ability of physicians to keep their patients healthy (i.e. valuing quality of care over quantity of care) How the heck could that work in pathology? Pathology is a widget based profession, and I think there is no other way for us to be reimbursed other than being paid by the widget.

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[KluverB]

Sure there is: salary.

 

[pathstudent]

Sure there is: salary.

Of course it will be salaried, but I think I figured it out.

Pathologists will be part of ACOs and responsible for providing pathology for a large group of patients. Salary will be determined by whoever is running the ACO whether it be a hospital or group of physicians or both. If the patients stay well, you have less work to do and so you will be getting paid more per service than if your patients are sick and you have to provide lots of pathology services meaning you are getting paid less per service. That way quality will be valued over quantity.

I think CAP had a webinar recently on this. Wish I would have heard it.

 

[KCShaw]

Were that the case it makes it sound like the sickest patients with therefore the greatest need are more likely to be taken care of by those with the highest workload and supposedly of the least quality. It wouldn't take a genius to expect the system to layer out in an ugly sort of pyramid.

Of course, in pathology we also know that we can't directly control clinical decision making. Not that we aren't involved in the health of any given patient, nor that quality outcomes aren't in part dependent on the quality of pathology services, but it's a limited component.

I also don't accuse anyone of putting much thought into changing The System, nor do I declare any system likely to be without flaw.

 

[Autopsy101]

A recorded version of the webinar will be available in 2 weeks on the CAP website.