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Reimbursement for autopsies. A personal view
Insights
Hospitals may reduce autopsies due to new reimbursement models. Funding for postmortem examinations must shift from health insurance to research and education to preserve their community benefits.
Area of Science:
- Medical reimbursement policies
- Pathology and autopsy services
Background:
- Historically, Medicare Part A and Blue Cross reimbursed postmortem examinations.
- The implementation of diagnostic-related group reimbursement is anticipated to decrease autopsy rates in hospitals.
- Private payers are likely to exclude autopsy coverage to manage costs.
Purpose of the Study:
- To analyze the financial impact of changing reimbursement models on autopsy services.
- To propose alternative funding strategies for preserving autopsy benefits.
Main Methods:
- Analysis of current and projected healthcare reimbursement structures.
- Review of the financial implications for pathology departments and hospitals.
- Identification of stakeholders and potential funding avenues.
Main Results:
- Diagnostic-related group reimbursement is expected to lead to cost-cutting measures, including reduced autopsies.
- Third-party payers are likely to discontinue autopsy coverage.
- Existing insurance subsidies for certain costs may be phased out.
Conclusions:
- Autopsies provide demonstrable community benefits that are at risk due to financial pressures.
- A shift in funding from health insurance to research and education is necessary to sustain autopsy services.
- The College of American Pathologists faces the challenge of developing independent funding streams for autopsies.
Abstract:
Postmortem examinations have been reimbursed under Part A of Medicare and as a reimbursable expense of the pathology department by Blue Cross. As diagnostic-related group reimbursement is implemented, hospitals are likely to cut costs by reducing the number of autopsies. Third-party payers representing the private sector will protect the interests of their subscribers or clients by excluding autopsies from coverage. To preserve the clearly demonstrable benefits that the autopsy has for the community, it will be necessary to include the autopsy as a cost of research and education. There are other costs that traditionally have been subsidized by insurance that must also be shifted to research and education. The challenge for the College of American Pathologists is to work with those with similar interests to develop funding separate and distinct from health insurance.
