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OIG Tells CMS It Could Save $910 Million on Lab Test Costs

IT IS ONE MORE POWERFUL SIGN of the changing times. Last week, the Office of the Inspector (OIG) publicly released a study it had done of the prices paid for lab testing and how the Medicare program could use this information to reduce the cost of Part B clinical laboratory testing. It was The W…

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Health Insurers See Big Increase in Lab Utilization

CEO SUMMARY: In a recent public workshop, managed care executives revealed that the annual cost of outpatient laboratory testing is increasing at twice the rate of all other medical services. One big driver in the increased spending on lab testing is increased utilization…

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Aetna To Lower Lab Test Prices, New Fees Are Effective on July 1

IN RECENT MONTHS, labs are reporting the receipt of letters from Aetna, Inc., announcing that it will pay dramatically less than Medicare prices for many key lab tests. Aetna said that these lower prices will take effect on July 1, 2013. Three examples illustrate the deep fee cuts t…

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Executive War College Sessions Center Upon Three Trends

CEO SUMMARY: There was an interesting blend of anxiety and optimism as a record crowd gathered in New Orleans last week for the 18th annual Executive War College on Laboratory and Pathology Management. The anxiety was rooted in the shrinking prices paid by payers for lab testing services….

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Low 2013 Molecular Rates May Bankrupt Some Labs

CEO SUMMARY: Many of the recently issued reimbursement rates for molecular diagnostic tests are inadequate and in fact are lower than the cost of running the tests, lab experts say. Smaller laboratories that specialize in developing and selling molecular tests could be forced to close. As…

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ACO Numbers Increase, Now Cover 10% of Nation

CEO SUMMARY: A recent report by a consulting firm that tracks the ACO industry indicates that, as of the end of 2012, ACOs of all types involved—in some manner—between 25 and 31 million patients. Moreover, Medicare and private ACOs are located in regions where 45% of the population of…

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Manhattan Labs Gets Infusion of Equity Cash

CEO SUMMARY: Manhattan Labs tapped a private equity company for growth capital last month. The company says its strategy is to deliver concierge-level quality lab services to the high-end physicians and patients within the tri-state area of New York, New Jersey, and Connecticut. These are…

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February 11, 2013 “Intelligence: Late Breaking Lab News”

Would it surprise you to learn that just five organizations control 91% of California’s health insurance market? At the top of the list is Kaiser Permanente, which holds a 40% share of the California market. Following, in order, were Anthem Blue Cross (23%), …

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Delivering Added Value = More Lab Reimbursement

WILL HISTORY LOOK BACK ON 2013 AND DECLARE IT to have been a watershed year for the clinical laboratory testing industry? I ask that question because many of you are telling us here at THE DARK REPORT that you expect rapid and unprecedented changes in the lab testing marketplace in your community or …

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Boosting the Lab’s Role in Collaborative Care

CEO SUMMARY: Collaborative care is an essential element of accountable care organizations (ACO) and other emerging models of integrated clinical care. At MedCentral Health System, one clinical chemist has held a key place on the physician team that develops order sets and clinical alerts….

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