The Dark Report

Payers Request More Claims Documentation

CEO SUMMARY: Both anecdotal evidence from lab professionals and numbers-based data from XiFin point to a problem: More payers require clinical labs to produce more documentation that a test claim is valid. Automated denials and inconsistencies in applying denial codes are contributors to this unwelcome trend in how payers process claims. MORE PAYERS ARE REQUIRING …

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Kaiser Acquires Geisinger Health in Value-Based Deal

CEO SUMMARY: This blockbuster combination of two respected integrated delivery networks (IDNs) caught the hospital industry by surprise. Post-closing, Kaiser and Geisinger will have combined revenue of $100 billion. Kaiser is creating a new entity called Risant Health. Geisinger will be the first IDN put into Risant Health and Kaiser plans to acquire and add …

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Healthcare Megatrends and a Famous Book

PREDICTING THE FUTURE IS A RISKY BUSINESS. SKEPTICS ARE ALWAYS AROUND TO CALL ATTENTION TO PROPHETS WHO GET IT WRONG. One prophet whose predictions were on target was author John Naisbitt. Those of us around in the 1980s will remember a book titled, “Megatrends: Ten New Directions Transforming Our Lives.” This was a blockbuster book …

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Kaiser-Geisinger Acquisition Sets Stage for More Deals

CEO SUMMARY: Even as experts were predicting more consolidation among multi-hospital health systems at the Executive War College in New Orleans last month, acquisition of Geisinger Health by Kaiser Permanente was announced. Not only does the deal confirm the consolidation trend involving hospitals, but it also sets the stage for advances in value-based reimbursement models. …

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Major Events on Horizon to Reshape Lab Market

CEO SUMMARY: Speakers at last month’s Executive War College discussed a range of significant trends and changes happening today in the U.S. healthcare system. Two of the most important trends are consolidation of multi-hospital health systems and the growing demand for lab test data—particularly when combined with other types of data add value and improve …

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Lab Execs Allegedly Lied to FDA about Faulty Tests

CEO SUMMARY: Three former executives of a lab testing company face criminal charges. Federal prosecutors claim that the three plaintiffs who previously worked at Magellan Diagnostics flagrantly hid information from the Food and Drug Administration about inaccurate lead poisoning test results delivered via its devices. Corrections were later made to the product, sold under the …

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Quest, Labcorp Both Report Growth in Base Lab Business

DURING THE LATEST QUARTERLY EARNINGS REPORTS from Quest Diagnostics and Labcorp, it was largely “same old, same old” as base business continues to improve post-pandemic, while COVID-19 test demand drops. However, interesting insights about the status of the clinical lab marketplace were shared during the first quarter earnings calls. During the Quest Q1 2023 earnings …

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May 8, 2023, Intelligence: Late-Breaking Lab News

Responding to the need to expand access to training for diagnostic testing professionals, the CDC’s Division of Laboratory Systems has launched OneLab TEST (Timely Education and Support of Testers). OneLab TEST is an online network for those who perform diagnostic medical testing at non-laboratory sites, such as retail pharmacies, physician offices, and schools. The CDC …

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What’s Next in 2023 for Clinical Laboratories?

AS YOU OPEN THIS ISSUE OF THE DARK REPORT, in New Orleans, about 900 senior lab administrators, executives, and pathologists will be gathered at the 28th annual Executive War College on Diagnostics, Clinical Laboratory, and Pathology Management. One big question that will be asked is: What’s next for clinical labs during the balance of 2023? …

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Draft Rule Standardizes Electronic Signatures

CEO SUMMARY: Every year, payers refuse laboratory test claims on grounds that the ordering provider’s signature is missing or illegible—a situation that costs clinical labs million of dollars in missed reimbursements. This situation might change once a proposed rule from the U.S. Department of Health and Human Services is implemented that defines and standardizes physician …

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