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.
Anatomic Path Trends Portend Deep Changes
CEO SUMMARY: Our biannual review of trends shaping the anatomic pathology profession reveals that a wide range of influences are active. The nation’s healthcare system is undergoing fundamental changes in how it views the quality of health services and how it will favor top-performing p…
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Pathology Part A Comp Under Attack by Both Hospitals and Insurers
CEO SUMMARY: In steadily-growing numbers, hospitals and insurers are taking active steps to reduce or eliminate compensation for clinical pathology professional services, also commonly referred to as “Part A” services. Unfortunately, many pathology groups fail to anticipate this situati…
Path Trends For 2002 Show Future Direction
CEO SUMMARY: Even as pressures to squeeze costs and consolidate within the pathology profession ease, a different set of market trends is exerting influence. Collectively, these trends portend the end of the small pathology group’s dominance of its local healthcare marketplace. It will …
Histology Lab Goes Mobile To Serve Customers On-Site
CEO SUMMARY: During the 1990s, pathologists at Palm Beach Pathology recognized that more and more procedures were being done in ambulatory surgery centers and physicians’ offices. To maintain access to these patients, Palm Beach Pathology developed a strategic marketing plan with a uniq…
New Legal Trends Now Affecting Pathologists
CEO SUMMARY: During the past 36 months, quiet and significant changes have occurred to certain legal issues involving anatomic pathology services. The resulting new environment exposes pathology groups to different types of threats, particularly to their sources of income. This intelligen…
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Volume XXXII, No. 6 – April 21, 2025
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