Since 1995, Reliable Business Intelligence for Clinical Laboratories, Pathology Groups and Laboratory Diagnostics
FOR MORE THAN 20 YEARS, THE CLINICAL LAB INDUSTRY been marked by a fundamental schism. On one side of the schism are the public lab companies that have aggressively used deeply-discounted loss-leader pricing practices when negotiating managed care contracts to capture market share.
CEO SUMMARY: It’s a case of the little fish gobbling the big fish, as Opko Health—with revenue of $91 million—will be acquiring Bio-Reference Laboratories, with revenue of $832 million. But the more interesting aspect of the story is that the CEO of Opko Health is a physician worth $5 billion and highly respected by Wall Street. It could be that Bio-Reference CEO Marc Grodman, M.D., has gained a shrewd advisor and powerful ally in Phillip Frost, M.D., the Chair and CEO of Opko Health.
CEO SUMMARY: Since 2011, state officials in California have aggressively cut laboratory testing fees for Medi-Cal, the state’s Medicaid program. Now state officials say they will implement a new methodology next month for determining lab testing fees. The new methodology is based on lab pricing data produced as a result of whistleblower lawsuits against labs that were settled in 2011. Should prices fall below the costs of performing these tests, the Medi-Cal program may see legal challenges from the lab industry.
ANOTHER SIGN OF HEALTHCARE’S TRANSFORMATION came on June 1 when Sysmex Corporation of Kobe, Japan, and Laboratory Corporation of America in Burlington, North Carolina, announced a unique collaboration to develop blood-based molecular diagnostic tests for cancer.
The collaboration calls for Sysmex, a major in vitro diagnostics (IVD) manufacturer with expertise in hematology testing, to work with LabCorp. Efforts will center around two assays developed at Sysmex Inostics, called OncoBEAM and Plasma-Sequencing.
CEO SUMMARY: Medicare’s decision to cease covering many pharmacogenomic tests puts as many as 19 million Americans who have genetic variations affecting their response to medications at risk. These medications are commonly prescribed for patients with cardiovascular disease, pain, depression, anxiety, and cancer. Meanwhile, medical centers such as Mayo Clinic are conducting clinical studies to collect evidence that appropriate use of pharmacogenomic tests can improve patient outcomes while also reducing the cost of care.
ARE CLINICAL LABORATORIES and pathology groups prepared for ICD-10? Or, perhaps a better question to ask is this: Are Medicare Administrative Contractors prepared to switch to ICD-10 on October 1?
PHYSICIANS WHO PARTICIPATE IN schemes that violate anti-kickback and fraud statutes will be at greater risk of prosecution by federal healthcare officials. This development comes following the June 9 release by the OIG of “Fraud Alert: Physician Compensation Arrangements May Result in Significant Liability.”
Turf wars are breaking out among local pathology groups as consolidation involving hospitals and physicians’ practices continues to reshape many regional healthcare markets.
CEO SUMMARY: Medicare’s decision to cease covering many pharmacogenomic tests puts as many as 19 million Americans who have genetic variations affecting their response to medications at risk. These medications are commonly prescribed for patients with cardiovascular disease, pain, depression, anxiety, and cancer. Meanwhile, medical centers such as Mayo Clinic are conducting clinical studies to collect evidence that appropriate use of pharmacogenomic tests can improve patient outcomes while also reducing the cost of care.
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