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.
Lakewood Pathology Changes Leadership
CEO SUMMARY: Following the arrival of a new majority owner and a capital commitment of $50 million last year, Lakewood Pathology Associates has taken additional steps to pursue growth. Lakewood plans to acquire small to mid-sized companies that are complementary to its position in the ana…
“In-Office Pathology Mini-Labs” Offered by Physician GPOs
EARLIER THIS MONTH, two large physician GPOs (group purchasing organizations) announced that they had signed national agreements with a company that would “provide in-office pathology laboratories to their gastroenterology, urology, and dermatology member physicians.” The pathology company is th…
Technical/Professional Billing Split Is A Threat to Pathology
EACH SECOND YEAR, when we publish our bi-annual trends in anatomic pathology, we get feedback from our clients and regular readers. This year, a particularly insightful letter was received. The writer wants to add another trend to our list of 11. He puts forth his arguments in the letter we reproduc…
Many Trends in AP Spell Lots of Change Ahead
CEO SUMMARY: Every second year, THE DARK REPORT releases its list of key trends in anatomic pathology. These trends help shape an understanding about the state of the pathology profession. Our current list includes 11 identifiable trends. This is not an auspicious sign for pathologists wh…
AD PathLabs Is Closed, Assets & Clients Are Sold
CEOSUMMARY: AD PathLabs, Inc. was a regional anatomic pathology company built around a unique business model: It would provide technical AP services to local hospitals and other clients and allow referring physicians to perform the professional services on the cases they referred to AD Pa…
Failure of AD Pathlabs: Structural Weakness?
CEO SUMMARY: AD PathLabs is the latest in a string of business disappointments. Over the past decade, a number of anatomic pathology companies have proven that they can grow rapidly—attracting substantial volumes of specimens. But these companies seem to hit a financial wall that leads …
Congressional Bill Introduced On Cytology Proficiency Testing
THERE’S A NEW CHALLENGE to the near-monopoly on cytology proficiency testing held by Midwest Institute of Medical Education(MIME) of Indianapolis, Indiana. Last Friday, the College of American Pathologists (CAP) announced a new bill in the House of Representatives…
Innovative AP Reports Created by Path Group
CEO SUMMARY: Too often local pathology groups fail to react to intensified sales competition for the biopsy referrals of clinicians in their community. In Torrance, California, the 30 pathologists of Pathology, Inc. decided it was time to invest capital and resources into developing their…
Direct Access Testing Must Serve Consumers
CEO SUMMARY: As growing numbers of people enroll in consumer-directed healthcare benefit programs, laboratories will need to develop ways to directly service the needs of patients interested in ordering their own laboratory tests. That’s one reason Pathology Associates Medical Laborator…
Physician Group Path Ventures To Undergo OIG Review in 2005
IN ITS FISCAL YEAR 2005 WORK PLAN, the Department of Health and Human Services (DHHS) Office of Inspector General (OIG) will “identify and review relationships between physicians who furnish pathology services in their offices and outside pathology companies.” I…
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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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