This is an excerpt from a 1,565-word article in the Feb.4 issue of THE DARK REPORT.
The full article is available to paid members of The Dark Intelligence Group.
CEO SUMMARY: With most hospitals now included as “applicable laboratories” in the PAMA Medicare price reporting guidelines and required to report their private payer lab test price data, this incisive
CEO SUMMARY: It’s been a common strategy among managed care payers to seek the lowest prices for clinical laboratory testing when negotiating contracts with labs. However, lower prices may become less important over time as the health system moves away from fee-for-service payment toward value-based reimbursement. Now evidence is accumulating that at least some large
CEO SUMMARY: Will clinical labs heed the lessons learned from the first PAMA private payer market price reporting cycle that CMS conducted in 2017? One major difference is that the definition of applicable laboratories now includes most hospital labs. This creates the opportunity for a larger number of clinical labs to submit their price data
By any measure, it is tougher today for clinical laboratories and anatomic pathology groups to generate the revenue needed to deliver state-of-the-art diagnostic testing services while remaining financially viable. Four recent trends prove the point.
First, every year, the Medicare program and private health insurers are cutting the prices they pay for medical laboratory tests.
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 prices is proving to be an indiscriminate tool that is poised to undermine the financial integrity of many labs,
CEO SUMMARY: In Toledo, Ohio, ProMedica Laboratories uses extensive metrics to analyze almost all processes in the lab. Under a process improvement program in place for more than five years, the lab has implemented daily management to help streamline day-to-day operations. Concurrently, a newly-formed cross-functional test utilization team adopted recommendations from the Choosing Wisely campaign
CEO SUMMARY: With so many market forces working against the economic interests of clinical laboratories, it is essential that all labs develop appropriate strategies designed to sustain the quality of laboratory testing services and the financial integrity of the laboratory organization. In this intelligence briefing, XIFIN, Inc.’s CEO, Lâle White, explains five strategies that are
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 test prices and use that
Pathologists at the Houston Methodist health system created a website that tracks confirmed flu cases in real time. It is located at: https://flu.houstonmethodist.org and uses epidemiology data from the eight hospitals in the health system. The system updates every morning by polling the previous day’s data in the laboratory information system. Wesley Long, MD, an Assistant
CEO SUMMARY: Sonic Healthcare, Ltd., announced that it would pay $540 million—a multiple of 9.2 times EBITDA—to acquire Aurora Diagnostics, the anatomic pathology company based in Palm Beach Gardens, Fla. Sonic will gain 32 pathology practice sites and add 220 pathologists to its network of regional clinical and pathology laboratories. The transaction marks the end