Clinton tips his hand on Medicare cuts - Pres. Bill Clinton; proposals for reduced medicare payments - Washington Report - Column

Medical Laboratory Observer, April, 1993 by David Albertson

* Administrative waste and inefficiency should be reduced. AACC supports efforts to streamline Federal paperwork by introducing electronic billing and standardizing simpler reimbursement forms.

The idea of shared sacrifice may be crucial to the debate in months ahead since the stakes described by Clinton are high. As he said in February, "All of our efforts to strengthen the economy will fail unless we also take this year bold steps to reform our health care system."

Are tougher regs needed for laboratories?

Tougher regs may be needed to make sure patients get the most risk-free testing available, says a study just published in the Journal of the American Medical Association.|1~

The research study looked at Medicare patients from six states who died or were hospitalized for strokes or heart attacks within six days after receiving a test for prothrombin time, which doctors use to decide whether to adjust blood clotting medication. A high number of testing errors would result in more patients suffering heart attacks or strokes, researchers theorized.

The study found, among other things, that patients tested in a physician office lab performing fewer than 40 tests per month had nearly twice the likelihood of stroke and three times the chance of heart attack. Patients who lived in New York and Pennsylvania (states known for tough inspection and licensing regs) were found to be at less risk of bad medical outcomes, leading analysts to suggest that more stringent rules may be in order nationwide.

Reference

1. Mennemeyer ST, Winkelman JW. Searching for inaccuracy in clinical laboratory testing using Medicare data: Evidence for prothrombin time. JAMA. 1993; 269(8): 1030-1033.