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avalon healthcare solutions
Coverage, Reimbursement Still Difficult for New Lab Tests
By Robert Michel | From the Volume XXIX, No. 11 – August 8, 2022 Issue
CEO SUMMARY: Bringing a new proprietary diagnostic test to market is an arduous process. It takes patience and planning to complete the journey from test development to payer reimbursement. This slow process stems from the fact that the healthcare reimbursement system is fragmented,…
Optum to Offer Laboratory Benefits Management to other Health Plans
By Robert Michel | From the Volume XXIX, Number 9 – June 27, 2022 Issue
This is an excerpt of a 1,355-word article in the June 21, 2022 issue of THE DARK REPORT. The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: UnitedHealth Group subsidiary Optum announced a new laboratory benefits management program aimed at impr…
UnitedHealth’s Optum to Offer Lab Test Management
By Robert Michel | From the Volume XXIX, Number 9 – June 27, 2022 Issue
CEO SUMMARY: UnitedHealth Group subsidiary Optum announced a new laboratory benefits management program aimed at improving utilization of genetic/molecular clinical laboratory testing. The goal is to save health plans money while bringing genetic test validity data prominently into …
TOP 10 LAB STORIES OF 2017
By Robert Michel | From the Volume XXIV No. 17 – December 11, 2017 Issue
1. CMS Sticks by Decision to Deeply Cut Medicare Part B Lab Test Fees SHORT OF A MIRACLE, the clinical laboratory industry is less than three weeks from the single most financially-disruptive event of the past 30 years. On Jan. 1, the federal Centers for Medicare and Medicaid Service…
2015’s Top 10 Lab Stories Show Significant Changes
By Robert Michel | From the Volume XXII, Number 18 – December 28, 2015 Issue
CEO SUMMARY: During 2015, two stories captured the full attention of most pathologists and clinical lab managers. One was how CMS intends to gather lab price market data as mandated by PAMA. The other was the continued efforts by the FDA to move ahead on proposed guidance for regulation o…
New Company Targets Lab Benefit Management
By Robert Michel | From the Volume XXII, Number 16 – November 16, 2015 Issue
CEO SUMMARY: Soon, the nation’s newest laboratory benefit management company will begin working for Blue Cross Blue Shield of South Carolina. Avalon Healthcare Solutions committed to BCBSSC that it can save money off what the health plan has been spending on clinical lab testing. It wil…
CURRENT ISSUE

Volume XXX No. 2 – January 23, 2023
The Dark Report explores the decision by The Joint Commission to no longer accept COLA-accredited facilities at its own accredited organizations, and reprints the letters sent by both TJC and COLA relative to the move. In other news, CLIA changes are coming and The Dark Report has an exclusive interview with a member of the committee studying those potential changes.
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