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capitated payment

Northwell Health Lab Team Leverages Data to Add Value

CEO SUMMARY: Today, insurers get risk-adjusted payments for treating patients who have high-cost health conditions and they make risk-adjusted payments to physicians, hospitals, and other providers. At Northwell Health, the clinical lab saw the opportunity to leverage lab test data with …

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University of Michigan Pathologists Bet on Patient-Centered Care

CEO SUMMARY: At the University of Michigan Medical Center, the Department of Pathology is learning new ways to add value that include face-to-face meetings with patients as part of UMMC’s patient- and family-centered care initiative. One lesson learned is that patients appreciate the op…

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State of Clinical Lab Industry Likely to Be Mixed in 2016

CEO SUMMARY: Over the next 24 months, it will be essential for every clinical laboratory and anatomic pathology group to develop clinical and financial strategies that meet the changing needs of health insurers, hospitals and health systems, physicians, and patients. THE DARK REPORT provi…

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Could Health Insurers Be at War with Clinical Labs?

CEO SUMMARY: It may sound ridiculous to assert that the nation’s largest health insurers are now “waging war” against clinical labs. However, some very smart people in the profession of laboratory medicine are expressing this opinion. To support such a conclusion, they point to paye…

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Lab Serving Large MD Group Manages Quality and Costs

 CEO SUMMARY: For decades, pathologists have pointed out that their expertise in laboratory medicine can be tapped by physicians to improve utilization of lab tests, contribute to improved patient outcomes, and reduce the overall cost of care. Exactly that is now happening at Atrius Heal…

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New Federal Law Changes How CMS Sets Lab Prices

CEO SUMMARY: CMS wanted more power to cut the prices it pays for clinical lab testing. A significant part of the lab industry wanted more transparency and consistency in how CMS established coverage guidelines and prices for new lab tests. Congress appears to have attempted to craft a law…

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Maine’s Spectrum Medical Group Offers Multiple Specialties

CEO SUMMARY: Pathologists looking for a viable future in a healthcare system marked by integration of clinical care and value-based reimbursement will be interested to learn about Spectrum Medical Group based in Portland, Maine. This 180-member multispecialist group includes 22 pathologis…

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AG Jerry Brown Settles With Westcliff Med Labs

CEO SUMMARY: In California, Attorney General Jerry Brown is making progress in the whistleblower lawsuit alleging that seven lab companies in California violated state law by not giving Medi-Cal, the state’s Medicaid program, the same lowest lab test prices they extend to physi…

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June 12, 2006 “Intelligence: Late Breaking Lab News”

Many changes are unfolding across the laboratory industry, so we begin with some of the more significant developments involving people: TRANSITIONS •One of clinical pathology’s respected veterans is preparing to retire. Elkin Simson, M.D., Medical Director at th…

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Provider Performance Ranking Now Hitting Healthcare System

CEO SUMMARY: When 96 big corporations, employing 28 million people and spending $52 billion on healthcare, begin publishing hospital performance measurements so their employees can make informed choices, that’s big news! THE DARK REPORT predicts this is a major step toward detailed meas…

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