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.
Tissue Banking May Be Source Of New Pathology Revenues
CEO SUMMARY: Evidence is accumulating that tissue banking may be where the “rubber meets the road;” where pharma money funds technology enhancements that directly benefit the profession of pathology. Without question, the need by pharma, biotech, and genomic companies to access, analy…
Merger Creates “New” Pathology Competitor
CEO SUMMARY: Pathology business consolidation and regionalization continues. Pathology Consultants of America, Inc. (PCA) and PathSOURCE, Inc. announced their intention to merge last month. The combined company will be called Inform DX, Inc. and will compete nationally for anatomic pathol…
AmeriPath Pursues Ambitious Strategy Of Rapid Expansion
CEO SUMMARY: As the pathology profession’s only publicly-traded physician practice management company, AmeriPath is the spear point of far-reaching changes now transforming pathology. With an annual revenue run rate of $270 million and an ample war chest of growth capital, AmeriPath int…
Single-Specialty Path PPMs Posting Strong Growth, Profits
CEO SUMMARY: Although the financial travails of the physician practice management (PPM) industry are widely known, there is little recognition that a number of single-specialty PPMs are doing well. This is true of pathology, where at least six pathology-based PPMs still remain in business…
Pathology Profession Facing New Directions
CEO SUMMARY: Big changes ahead during the next decade. Among the predictions: the number of two and three-pathologist group practices will radically diminish; pathology centers of excellence will achieve new market dominance; and…ever more intense competition for anatomic pathology spec…
Individual Pathologist “Branding” Promoted by National Firms
IN THE EFFORT TO GAIN COMPETITIVE market advantage, IMPATH, Inc. of New York City publicized the recent signing of an exclusive partnership agreement involving renowned pathologist Juan Rosai, M.D., also of New York City. Dr. Rosai has a world-wide reputation for his books, book cha…
Pathology Consolidation Offers Many Local Benefits
CEO SUMMARY: Consolidation of pathology practices can be a complex and drawn-out process. But it doesn’t have to be that way. During the 1990s, Bayless Pathmark of Cleveland grew from a two-man practice into a regional pathology resource numbering 22 pathologists and serving 10 hospital…
PPM Giant MedPartners Exits Doctor Management
THIRD IN A SERIES WHAT DOES IT MEAN WHEN the largest companies in a multibillion dollar industry announce that they will “get out” of that business? That is the question which must be answered after MedPartners, Inc. joined PhyMatrix Corp. in p…
PathSOURCE Is Newest Pathology Consolidator
CEO SUMMARY: Based in New York, PathSOURCE becomes the newest pathology network and services company to hit the market. PathSOURCE’s organizers want to link “best in class” dermatopathologists and academic pathology subspecialists to compete for outreach pathology specimens. PathSOU…
Pathologists Will Learn Income-Boosting Methods
CEO SUMMARY: Reimbursement for pathology services continues to decline. Despite this fact, savvy pathologists throughout the country are steadily increasing their take-home income. Their proven methods and secret strategies will be the theme of the Private Pathology Income Symposium. This…
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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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