Lawsuits Allege LabCorp, Quest Overcharged Uninsured Patients

By Joseph Burns

CEO SUMMARY: Court documents filed in U.S. District courts in New Jersey and North Carolina provide details about how each of the two lab companies set lab test prices differently—as much as 10 times higher—for cash-paying patients than for patients who have Medicare, Medicaid, or com…

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The Bad News: Disruption. The Good News: Opportunity!

By Robert Michel | From the Volume XXVI No. 7 – May 20, 2019 Issue

CEO SUMMARY: There was an interesting consensus that emerged from the 80 sessions and 118 speakers at this year’s Executive War College in New Orleans earlier this month. The consensus centered around two themes. One theme is disruption, which is bad news for those labs that hope to mai…

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Patient Care Focus Helps Path Group Win Contract

By Joseph Burns | From the Volume XXVI No. 3 – February 25, 2019 Issue

CEO SUMMARY: When Ascension Wisconsin wanted one pathology group to serve its needs statewide, North Shore Pathologists responded to the request for proposal by focusing on how pathologists can improve patient care through a patient-centered model. Other pathology groups responded with pr…

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Why PAMA May Be Poised to Disrupt Lab Industry

By Robert Michel | From the Volume XXVI No. 1 – January 14, 2019 Issue

CEO SUMMARY: This will be one of the most challenging years facing the clinical lab industry since the early 1990s, when closed panel HMOs were the disruptive force that generated deep cuts in lab test prices. However, unlike HMOs of that era, the CMS scheme to collect private payer lab t…

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Is There a Future for Hospital Lab Outreach Programs?

By Mary Van Doren | From the Volume XXVI No. 1 – January 14, 2019 Issue

CEO SUMMARY: This will be one of the most challenging years facing the clinical lab industry since the early 1990s. The CMS scheme to collect private payer lab test prices and use that data to set Medicare clinical laboratory test pric…

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U of Florida Health Improves Patient Care with PGx Testing

By Joseph Burns | From the Volume XXV No. 17 – December 3, 2018 Issue

CEO SUMMARY: Since 2011, the University of Florida Health System has used pharmacogenetic test (PGx) results to guide physicians when they prescribe certain drugs. This initiative has improved patient outcomes, reduced the overall cost per episode of care, and gained partial reimbursemen…

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Project Santa Fe Labs Deliver Value with Tests

By Joseph Burns | From the Volume XXV No. 16 – November 13, 2018 Issue

CEO SUMMARY: No bigger threat looms over the financial security of the nation’s clinical laboratories than healthcare’s transition from fee-for-service payment to value-based reimbursement. To navigate that transition successfully, medical labs and pathology groups will need to adopt …

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Sonic Uses Lab Data, Patient-Contact Tools, to Improve Outcomes

By Joseph Burns | From the Volume XXV No. 16 – November 13, 2018 Issue

CEO SUMMARY: In its work for a federally qualified health center, Sonic Healthcare USA helped physicians use a data-driven approach to population health management that incorporated integrated financial and clinical analytics. Also, Sonic developed technologies that give ordering physicia…

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New Aetna, UHC Contracts Create Openings for Labs

By Joseph Burns | From the Volume XXV No. 11 – July 30, 2018 Issue

CEO SUMMARY: New national lab contracts that LabCorp and Quest announced in May could disrupt the lab testing market in ways regional labs can exploit, experts said. Health plans entered these new contracts after realizing that the exclusive network contracts do not work, one lab consulta…

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Did National Labs Sign Value-based Payer Contracts?

By R. Lewis Dark | From the Volume XXV No. 8 – May 29, 2018 Issue

IT IS AN IMPORTANT SIGN OF THE TIMES when press releases about the two new national lab services agreements that UnitedHealthcare just announced with Laboratory Corporation of America and Quest Diagnostics emphasize how value-based programs will be a…

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