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CMS’ Proposed Lab Rules May Not Fly with Congress

CEO SUMMARY: Many clinical lab administrators have noticed the new activism at the federal Centers for Medicare Medicaid Services (CMS) when it comes to control of establishing prices for clinical laboratory tests. In this exclusive interview, two long-time advocates for the National Inde…

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Hospitals Recognize Need for Uniform Lab Test Data

CEO SUMMARY: Hospitals may soon insist that payers allow their in-house labs to provide outpatient testing regardless of exclusive managed care contracts with national lab companies. The migration to accountable care organizations (ACOs) and medical homes makes it essential that physician…

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July 08, 2013 “Intelligence: Late Breaking Lab News”

In China, independent clinical laboratories are in a fast-growth mode. That’s the conclusion of RnRMarketResearch in a newly-issued survey of the clinical laboratory testing market in China. It estimates this market segment at US$407 million annually. RnR says that three lab companies meet …

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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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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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