Since 1995, Reliable Business Intelligence for Clinical Laboratories, Pathology Groups and Laboratory Diagnostics

May 2013

Financial Hurricane Hits Entire Lab Testing Industry

FOR ABOUT 18 MONTHS NOW, THE ENTIRE LABORATORY TESTING INDUSTRY has been hit by an ongoing series of painful cuts to lab test fees and announcements of more restrictive coverage guidelines. Even today, there is additional news of rock bottom prices to share with you. In this issue, you’ll read about Aetna, Inc.’s latest strategy …

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Much Uncertainty About Pay for Molecular Codes

CEO SUMMARY: Having gone unpaid since January 1 for the 114 new molecular CPT codes, many clinical labs and pathology groups have stopped running these tests or laid off staff. Some are considering closing their doors. Evidence indicates that certain Medicare contractors are deciding that some molecular tests are not medically necessary. Medicare officials launched …

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Health Insurers See Big Increase in Lab Utilization

CEO SUMMARY: In a recent public workshop, managed care executives revealed that the annual cost of outpatient laboratory testing is increasing at twice the rate of all other medical services. One big driver in the increased spending on lab testing is increased utilization of lab tests by physicians—particularly expensive molecular diagnostic assays and genetic tests. …

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Why One Molecular Diagnostics Company Closed Its Doors

CEO SUMMARY: When executives closed the doors of Pathwork Diagnostics last month, the simple explanation was that reimbursement for its proprietary molecular diagnostic test was inadequate. Indeed, that was part of the story. But other factors played significant roles in impeding growth at this lab company. Here is an inside look at six factors which …

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Aetna To Lower Lab Test Prices, New Fees Are Effective on July 1

IN RECENT MONTHS, labs are reporting the receipt of letters from Aetna, Inc., announcing that it will pay dramatically less than Medicare prices for many key lab tests. Aetna said that these lower prices will take effect on July 1, 2013. Three examples illustrate the deep fee cuts that Aetna is attempting to push onto …

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May 28, 2013 “Intelligence: Late Breaking Lab News””

Globalization of laboratory medicine continues to move forward. Two recent examples illustrate this trend. Earlier this month, the University of Pittsburgh Medical Center (UPMC) announced that it had entered into an agreement with the Citizens Hospital of Hyderabad, India, to form a clinical pathology laboratory in that city. The laboratory will be located on the …

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Unpaid for Molecular Tests, Some Labs Are Closing

THERE IS GREAT FRUSTRATION ACROSS THE LABORATORY MEDICINE PROFESSION on the subject of getting paid for claims covered by the new Tier I and Tier II molecular test CPT codes. We are now in the fifth month of the year and pathologists are still waiting for an acceptable resolution to this situation. Last week in …

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Executive War College Sessions Center Upon Three Trends

CEO SUMMARY: There was an interesting blend of anxiety and optimism as a record crowd gathered in New Orleans last week for the 18th annual Executive War College on Laboratory and Pathology Management. The anxiety was rooted in the shrinking prices paid by payers for lab testing services. The optimism was based on recognition that …

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Dartmouth Builds New Lab to Serve Growth in Testing

CEO SUMMARY: Demand for specialized reference and esoteric testing is so robust at Dartmouth Hitchcock Medical Center in New Hampshire that the academic center is building an expanded laboratory facility to accommodate the increased volume of tests it handles each year. A favorable trend supporting these developments is the steady decline in the cost of …

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Mass Spectrometry, Collaboration Produce Dramatic Results

CEO SUMMARY: When the Department of Pathology and Genomic Medicine at the Methodist Hospital in Houston, Texas, worked with the Pharmacy Services Department, the outcome was a dramatic reduction in the time needed to more accurately identify and treat the pathogens causing gram-negative bloodstream infections. This successful program reduced the average length of stay by …

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