Pathology Trends
Pathology groups face a number of challenging pathology trends in the era of radical healthcare reform.
One of the primary trends is that like clinical laboratories, these businesses are carrying significant and potentially unsustainable levels of unreimbursed services. Although bad debt and uncompensated care in the healthcare industry are not new, they have been increasing at the same time that downward pressure is being applied to pathology reimbursement.
Medical laboratories and pathology groups are also facing enormous levels of change in their clinical, regulatory and financial environments. As the Affordable Care Act is implemented, laboratories see downward pressure on reimbursement at both the federal and payer level, coupled with increased emphasis on efficiency and quality.
Labs and health care providers need to seriously consider moving toward a retail business model. Changes in the health insurance market are now requiring patients to pay more out of pocket, and the perfect storm of bad debt and decreased requirement is pressuring laboratories.
Other pathology trends include:
- Growing emphasis on the continuum of care
- Increasing patient interaction directly with the lab organization
- Mounting demands of interoperability across a proliferation of disparate information technology systems to achieve meaningful use
- Evolving requirements for communication and data sharing with payers, accountable care organizations (ACOs), health information exchanges (HIEs) and other trading partners
Industry observers say that responding to each of these trends requires access to the most complete set of patient data possible. Accurate patient identification and record consolidation is central to achieving these goals.
In addition, labs and pathologists are increasingly urged to add value to the testing services they perform by leveraging information technology. For instance, advanced health information technology can be deployed within clinical labs and pathology groups specifically to meet changing patient expectations, while supporting the needs of client physicians for optimal workflow.
Few Options for Pathology Groups Facing Anthem’s Payment Cuts
FACED WITH DEEP CUTS in payment for anatomic pathology professional component services from Anthem Inc., pathologist have only a few options in how they can respond, according to consultants who work with AP groups. “These are dire cuts to anatomic pathology reimbursement,” said…
Anthem’s Cuts in AP Fees Could Put Patients at Risk
CEO SUMMARY: Consultants who work with anatomic pathologists have several theories about why Anthem is enacting deep cuts of 50% to 70% for the professional component of many anatomic pathology services. While they have different ideas about what motivates the nation’s second largest he…
Is Pathology Workforce Stable or Shrinking?
CEO SUMMARY: After publishing research in JAMA Network Open showing a coming shortage of pathologists in the United States, the researchers heard from pathologists whose experience in the job market did not match what the researchers found. Anecdotal evidence indicates that the demand for…
Fewer Pathologists Means Tighter Market for Jobs
CEO SUMMARY: Pathologists seeking jobs will find that a more competitive job market is pushing salaries up over $300,000 per year on average. In addition, most new jobs come with a hiring bonus and funds for relocation of as much as $12,000 and for continuing medical education of $3,500. …
JAMA Study: 17% Fewer Pathologists Since 2007
CEO SUMMARY: The number of pathologists working in the United States declined by 17.53% from 2007 to 2017, according to recent research published in the Journal of the American Medical Association. When adjusted for the U.S. population, the researchers said the workforce of pathologists i…
Dr. Papanicolaou Honored by Google Doodle on May 13
Pathologists and medical laboratory professionals the world over had a surprise on May 13 if they used Google for an Internet search. The doodle on the Google search home page honored pathologist Dr. Georgios Papanicolaou, who developed the Pap smear test used to screen for cervical …
Patient Care Focus Helps Path Group Win Contract
CEO SUMMARY: When Ascension Wisconsin wanted one pathology group to serve its needs statewide, North Shore Pathologists responded to the request for proposal by focusing on how pathologists can improve patient care through a patient-centered model. Other pathology groups responded with pr…
UK’s NHS to Build Five New Digital Path and Imaging Centers
TO SHORTEN THE TIME FOR CANCER DIAGNOSES, the United Kingdom’s National Health Service (NHS) will open five new digital pathology and imaging centers that will use artificial intelligence. The digital pathology and imaging centers will open in Coventry, Glasgow, Leeds, London, and Ox…
Pathology Groups Should Act Now to Define Value
CEO SUMMARY: Payers and health system administrators generally agree that healthcare is moving away from fee-for-service toward value-based payment. Because adoption of value-based contracts is slower for pathologists than for other providers, pathologists have the opportunity to define h…
California Pathology Labs to Report Data to State’s Cancer Registry
HEALTHCARE BIG DATA IS ADVANCING in California and all pathologists in the Golden State will be required to submit data to the state’s cancer registry beginning in 2019. California’s new law to support the state’s cancer registry is the latest example of an effort to ensure the timely collecti…
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Volume XXXIII, No. 3 – March 2, 2026
The Dark Report highlights the six themes that will carry the 2026 Executive War College on Diagnostics, Clinical Laboratory, and Pathology Management,, including finance issues and AI. Also, we show how RCM automation helped one lab conquer billing headaches and increase revenue.
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