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.
Problems In PPM lndustry Affect Pathology Practices
DURING 1998, THE FINANCIAL WOES of many physician practice management (PPM) companies caught healthcare experts, investors, and financial experts by surprise. Problems with the PPM industry could not come at a worse time for the pathology profession. At the very moment that several pathology-based P…
MedPartners To Divest Hospital-Based MD Unit
CEO SUMMARY: Hospital-based pathologists are increasingly the target of buy-out offers by the emerging group of pathology based physician practice management (PPM) companies. But MedPartners decided that managing hospital-based physicians was something that was not in its best interest. W…
American Path Resources Bought By Pathology PPM
CEO SUMMARY: Here is first confirmation that Pathology Consultants of America has indeed purchased American Pathology Resources. The combination of the two pathology-based physician practice management companies demonstrates that the pathology industry is on the verge of rapid transformat…
Selling A Pathology Practice: Do’s, Don’ts & Pitfalls To Avoid
CEO SUMMARY: Physician practice management (PPM) companies represent a powerful new economic trend. Greater numbers of pathologists will soon confront a career-changing decision: should we sell our pathology practice to a PPM? Regardless of how pathologists answer that question, their bus…
Pathology PPM Appears Ready To Hit Marketplace
CEO SUMMARY: After several months of delays, Physician Solutions recruited a new CEO and completed arrangements to receive $20 million in venture capital funding. These two milestones mean that the pathology-based physician practice management company will soon be ready to launch formal b…
Selling A Path Practice Requires Knowledge, Savvy & Good Timing
CEO SUMMARY: Historically, there was virtually no market for buying and selling pathology practices. That is rapidly changing as the first pathology practice management (PPM) companies enter the marketplace. Their business plan requires them to acquire pathology practices if they are to g…
DIANON Systems Acquires Pathology Lab In Florida
CEO SUMMARY: Another national pathology player is betting on Florida. DIANON Systems, Inc.’s purchase of a local pathology laboratory raises the competitive bar in Florida. With AmeriPath and Pathology Service Associates already gearing up to battle for market share, DIANON’s local pr…
Pathology Competitors Make Florida The Target
CEO SUMMARY: Florida is about to become the marketing battleground for anatomic pathology. Three well-funded players are preparing to launch major sales efforts. Pathologists in the state wait with trepidation. Expectations of discounted pricing and a “gloves-off” sales strategy conce…
New Pathology PPM Hits Competitive Marketplace
CEO SUMMARY: Nashville hatched another pathology-based physician practice management firm. This newest competitor was capitalized by pathologists. Its arrival in the competitive marketplace signals further changes to the traditional practice of pathology. Increasingly, it will be business…
To Protect Pathology Profits: Understand Managed Care
CEO SUMMARY: On November 8, 1997, THE DARK REPORT convened a private symposium restricted only to pathologists. The sole purpose of this event was to identify how pathologists could preserve and enhance their income. Within the confidential setting of a plush resort in Scottsdale, Arizona…
CURRENT ISSUE
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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