WHAT ARE PATHOLOGISTS AND LAB EXECUTIVES TALKING ABOUT when they gather at lab industry conferences? If the hallway chats between sessions and dinner conversations that occurred last week at the 20th annual Executive War College are representative, then the clinical lab profession is closely tracking the UnitedHealthcare and BeaconLBS story on the East Coast (in Florida) and the Theranos story on the West Coast (California and Arizona).
Issue: Volume XXII NO. 7 - May 11, 2015
CEO SUMMARY: One stark difference between the presentations delivered at last year’s Executive War College and this year’s presentations in New Orleans last week was near-unanimous recognition that the era of fee-for-service payment is soon to end! Speaker after speaker urged the audience to accept this marketplace reality. The common recommendation was for lab administrators and pathologists to take immediate steps to help their laboratories respond to this development in effective ways.
CEO SUMMARY: Physician residents at the UCSF School of Medicine set a target of reducing unnecessary blood draws. By eliminating needless needle sticks, the residents are focusing on patient experience while also encouraging physicians to pay more attention to the need to decrease unnecessary clinical lab testing. The goal is a 5% reduction in phlebotomy procedures for the aca- demic year 2014 to 2015, compared with the previous academic year. Early results show a decrease in phlebotomy procedures.
CEO SUMMARY: Attorneys who advise pathologists and clinical laboratories on compliance issues say the number of audits from the government and third-party payers has increased sharply in recent years. In those audits, payers are looking for recoupment of overpayments. A lab’s failure to provide proper documentation during these audits can result in the need to pay sixand seven-figure amounts. Payers also are auditing out-of-network billing and patient balance billing.
RECENT DEVELOPMENTS MAKE IT SEEM as if lab test orders signed by physicians might soon go out of style. Last month in Arizona, Theranos played a role in changing a state law that now lets consumers order their own clinical laboratory tests without a physician’s order. Then, before the end of last month, Laboratory Corporation of America said it would expand its direct-to-consumer testing program nationwide.
CEO SUMMARY: Theranos now operates wellness centers in Walgreens in Palo Alto, California, and Phoenix, Arizona. It con- tinues to claim it is transforming the lab testing experience for patients and physicians. It says it can perform hundreds of lab tests, using a finger stick collection and a micro-specimen vial, and return results in four hours. Last month, our editor visited a Theranos wellness center in a Walgreens pharmacy with a test requisition for four lab tests. He reports here on the experience.
Last month, TriCore Reference Laboratories of Albuquerque, New Mexico, announced that it had purchased the Rhodes Group, of Vernon, Connecticut. Rhodes Group provides data integration services for labs and other healthcare providers. TriCore had long been a customer of Rhodes Group. TriCore is pursuing a strategy of leveraging lab test data with other clinical and healthcare data.
CEO SUMMARY: One stark difference between the presentations delivered at last year’s Executive War College and this year’s presentations in New Orleans last week was near-unanimous recognition that the era of fee-for-service payment is soon to end! Speaker after speaker urged the audience to accept this marketplace reality in laboratory industry trends. The common recommendation …