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.
Pathology Consolidation Underway in Washington
CEO SUMMARY: Two regional pathology super-practices have emerged in Washington State. In each case, acquisitions and mergers are fueling the growth of the two large pathology groups. In Western Washington and the Seattle metro, CellNetix is the dominant pathology group, with 53 physicians…
UCLA Pathologists to Open Joint Venture Lab in Shanghai
PATHOLOGISTS at the University of California Los Angeles Department of Pathology will participate in a unique commercial laboratory company that will be based in Shanghai, China. On April 8, UCLA announced a partnership agreement with Centre Testing International Corp….
Pathologists Top Earners in Medicare MD Pay Data
CEO SUMMARY: Never in 50 years had the Medicare program made public the money it pays physicians for Part B services— never until April 9, that is. On that day CMS revealed how it disbursed $77 billion to individual physicians during 2012. Newspapers and television reporters jumped on t…
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…
Better Data Needed to Support Pathologists as Consultants
MULTIPLE TRENDS ARE UNFOLDING that mutually reinforce the need for pathologists and PhDs to be experts and consultants in how physicians order and follow up on molecular diagnostics assays and genetic tests. “Healthcare in the United States is approaching a tipping point that can greatly favor pat…
Lawyers Share Insights about ACO Contracting
CEO SUMMARY: Most pathologists have yet to be involved in any substantial contractual negotiations that would allow them to assume a significant role in accountable care organizations (ACOs). Instead, hospitals and health systems are putting the building blocks in place by acquiring physi…
Pathology Labs Want Method To Correct Specimen ID Errors
CEO SUMMARY: When pathology labs discover instances of a misidentified or contaminated tissue specimen, there is a new service that allows them to retrospectively use DNA to properly match that specimen to the correct patient. In part two of our series, we look at how some pathology labs …
Pathologists Benefit from Hospital Lab Consulting
CEO SUMMARY: Deteriorating finances at many rural hospitals and smaller community hospitals is a growing trend. It is also a new consulting opportunity for local pathologists because financially-strapped hospitals often give their labs inadequate working capital and lack the staff needed …
Louisiana Pathologists ‘Moonlight’ as Consultants
CEO SUMMARY: Few independent pathology groups have developed robust laboratory consulting businesses. But adopting that strategy has brought important benefits to Delta Pathology Group, LLC, of Shreveport, Louisiana. Not only has providing lab consulting services to cash-strapped hospital…
Hospitals Get Bad News Re: TC Grandfather Expire
CEO SUMMARY: During negotiations to extend the payroll tax cut in February, Congressional negotiators agreed to end the technical component (TC) grandfather provision for more than 1,000 rural hospitals. Seeking to save $50 million annually, Congress said anatomic pathologists would no lo…
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Volume XXXII, No. 6 – April 21, 2025
Now that a federal judge has vacated the FDA’s LDT rule, The Dark Report analyzes the judgement and notes the various steps the FDA could take in response. Also, lab testing at pharmacies is proving to be less successful than was once anticipated.
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