Demonstration and Evaluation of Competitive Bidding as a Method of Purchasing Clinical Laboratory Services: Demonstration Design Report

摘要

The Demonstration Design Report provides detailed information on the competitive bidding methodology proposed for testing under Health Care Financing Administration's demonstration authority. The report discusses the concept of non-exclusivity, physician office laboratories, monopolization issues, quality and access issues, prevalence of competitive bidding in private health care, and model variations. The report is comprised of the following chapters: Background relating to competitive bidding and the laboratory industry; Theoretical issues relating to behavior in the clinical laboratory industry; Theoretical issues relating to physician office laboratories; Design features common to all sites; Recommended design; and Evaluation issues. Details contained in the report regarding the competitive bidding model include: (1) Who must bid; (2) Reimbursement for non-bidders; (3) Treatment of non-certified laboratories, certified hospital laboratories, and certified nursing home laboratories; (4) Site definition; (5) Tests subject to bidding; (6) Payments for special services; (7) Quality assurance; (8) Implementation procedures; and (9) Evaluation issues. The report includes comments from the panel members regarding the demonstration's design.