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10% PAMA Fee Cut Would Lower Medicare Pay to Laboratories by $400 Million

CEO SUMMARY: Just eight weeks remain before certain clinical laboratories must begin submitting private payer lab test price data to the federal Centers for Medicare & Medicaid Services. A new report …

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Medicare Part B Lab Test Prices Versus Budgeted Payment

THERE IS AN IMPORTANT QUESTION THAT lab industry magazines and news sources have failed to address: How many years are left before Medicare officials drop fee-for-service payment for clinical lab testing? On January 26, 2015, the Department of Health and Human Services (HHS) issued a press rele…

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BeaconLBS is coming to Texas

This is an excerpt from a 1,200-word article in the October 17 issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group. …

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How Reference Pricing Encourages Patients to Help Cut Cost of Care

USE OF REFERENCE PRICING by Safeway to lower the cost of clinical laboratory tests was the subject of a study published by JAMA Internal Medicine in July. In a special issue, THE DARK REPORT analyzed the study, which showed that reference-based pricing …

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Can Clinical Laboratories Adjust To ‘New’ Healthcare System?

CEO SUMMARY: Month by month, there is increased clarity in the path the American healthcare system will follow as hospitals, health systems, and physicians integrate clinical care, manage populations, and practice personalized and precision medicine. While these changes play out, clinical…

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UnitedHealthcare to Bring BeaconLBS to Texas

CEO SUMMARY: With a quiet announcement this month that it was bringing its laboratory benefit management program to Texas on March 1, 2017, UnitedHealthcare is taking on a big challenge. Enrollment in UHC’s commercial plans in Texas is 4.3 million. That is twice the two million commerci…

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Why Lab Prices Declined 32% During 3-Year Study

CEO SUMMARY: Researchers studied the effect reference pricing had on an employer’s efforts to steer consumers to low-cost clinical labs. The study showed that patients were particularly sensitive to lab test prices—in part because those prices varied widely. Over the course of the …

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Labs Caught Between Employer Hammer, Payer Anvil

STARTING ON JANUARY 1, 2017, THE CLINICAL LABORATORY INDUSTRY will undergo a new experiment in price-setting (and price-cutting) by the federal Centers for Medicare & Medicaid Services. On that date, certain labs must begin reporting market price data for each test and each payer…

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Castlight Health’s Data Should Concern Lab Executives

CEO SUMMARY: Transparency tools, such as those from Castlight Health, help consumers see the significant variation in clinical laboratory test prices. In this analysis, THE DARK REPORT argues that lab executives and pathologists should recognize how two factors are poised to change the st…

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Strategy Lowers CalPERS’ Price of Joint Surgeries

CEO SUMMARY: Probably the most-watched reference pricing program in healthcare to date was initiated by CalPERS. It focused on the variability in the prices of knee and hip replacement surgeries. Just as Safeway experienced a drop in clinical lab test prices of 32% in its reference pricin…

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