ous elements of a payment methodology are described and form the framework for analyzing the current outpatient clinical laboratory payment system.

The last three chapters present the committee’s conclusions about the current payment system and possible alternatives. Chapter 5 assesses the current system in light of the payment policy goals that the committee has articulated in this chapter. Chapter 6 examines alternative payment methods that could be used by Medicare. Chapter 7 presents the committee’s recommendations, based on its assessment of the current system and the benefits and feasibility of several modifications to it.

REFERENCES

Gustafson, T. January 20, 2000. Testimony before the IOM Committee on Medicare Payment Methodology for Clinical Laboratory Services. Washington, DC.

General Accounting Office (GAO). December 1987. Medicare: Lab Fee Schedules Produce Large Beneficiary Savings but No Program Savings. HRD-88–32. Washington, DC: GAO.

GAO. June 1991. Medicare Payments for Clinical Laboratory Test Services are too High. HRD-91–59. Washington, DC: GAO.


Health Care Financing Administration (HCFA). 1999. “Medicare Enrollment Trends, 1966–1998.” Web page, [accessed 6 July 2000]. Available at www.hcfa.gov/stats/enrltrnd.htm.


Klipp, J. 2000. Lab Industry Strategic Outlook 2000: Market Trends & Analysis. Washington, DC: Washington G-2 Reports.


Lewin Group. 2000. Outlook for Medical Technology Innovation: Will Patients Get the Care They Need? Report 1: The State of the Industry. Washington, DC: The Health Industry Manufacturers Association.


Managed Care On-Line (MCOL). 2000. Medicare+Choice Enrollment Penetration by State. Webpage: accessed July 6, 2000. Available at http://www.medicarehmo.com/mrepenrp.thm.

Morgan, D. June 30, 2000. More health plans quit Medicare. Washington Post, section A, p. 8.


Office of the Inspector General (OIG). January 1990. Changes are Needed in the Way Medicare Pays for Clinical Laboratory Tests. A-09–89–00031. Washington, DC: OIG.

OIG. January 1996. Follow-up Report to “Changes are Needed in the Way Medicare Pays for Clinical Laboratory Tests.” A-09–93–00056. Washington, DC: OIG.


Physician Payment Review Commission (PPRC). 1987. Annual Report to Congress, 1987. Washington, DC: PPRC.

PPRC. 1995. Annual Report to Congress, 1995. Washington, DC: PPRC.


Steiner, J.W., and J.M.Root. June 1999. The battle between hospital and commercial labs: Who’s winning? Clinical Laboratory News, p. 4.



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