By Joseph Burns, from the Volume XXIV, No. 10 – July 17, 2017 issue
CEO SUMMARY: In five months, Medicare officials will implement a new Part B clinical laboratory fee schedule based on private payer lab price data submitted by certain medical laboratories required to report that data. At this year’s Executive War College, the CEO of XIFIN, Inc., reported on her company’s analysis of the payer price data
By Joseph Burns, from the Volume XXIV, No. 9 – June 26, 2017 issue
CEO SUMMARY: Since 2014, a toxicology lab at the University of Colorado has used mass spectrometry to offer low-cost, accurate multi-analyte test panels that can detect hundreds of therapeutic drugs and drugs of abuse. However, CU Toxicology’s chief medical officer says health insurers are slow to accept this diagnostic technology, despite its demonstrated clinical benefit
By Robert Michel, from the Volume XXIV, No. 5 – April 3, 2017 issue
CEO SUMMARY: In a letter to the Texas Legislature, 20 Texas medical societies say UnitedHealthcare’s BeaconLBS program would be detrimental to patient care. The Texas Medical Association and the Texas Society of Pathologists said they were concerned that the program increases the administrative burden on referring physicians, takes away a physicians’ right to choose a
By Joseph Burns, from the Volume XXIV, No. 3 – February 21, 2017 issue
CEO SUMMARY: Following passage of the Protecting Access to Medicare Act of 2014, officials at PeaceHealth and PeaceHealth Laboratories began to model the financial effect this law would have on this long-established hospital lab outreach program. Based on projections of a 20% cut in revenue during the first two to three years of the Medicare
By Mary Van Doren, from the Volume XXIII No. 17 – December 19, 2016 issue
This is an excerpt from a 3,200-word article in the December 19 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.
CEO SUMMARY: THE DARK REPORT’S annual list of the Lab Industry’s Top 10 stories for
By Joseph Burns, from the Volume XXIII No. 17 – December 19, 2016 issue
CEO SUMMARY: In launching BeaconLBS in Texas, UnitedHealthcare included a new, more onerous twist than it used for BeaconLBS in Florida. To be a BeaconLBS in-network ‘lab of choice,’ a lab must be in the lowest quartile for lab test prices. Any lab above the 25th percentile would have to renegotiate its contract with UHC
By Robert Michel, from the Volume XXIII No. 17 – December 19, 2016 issue
CEO SUMMARY: Within THE DARK REPORT’S list of the Top 10 Lab Industry Stories for 2016 is one story of disruption that might have been one story of disruption about to happen. The disintegration of Theranos during 2016 is the big story about a self-proclaimed disruptor of the lab industry that finds itself struggling just
By Joseph Burns, from the Volume XXIII, No. 16 - November 28, 2016 issue
ON THE SUBJECT OF LAB TEST MARKET PRICE REPORTING as required under PAMA, many clinical laboratory executives, pathologists, and industry experts see deep flaws in the process the federal Centers for Medicare & Medicaid Services has established. Yet, CMS itself seems blind to these flaws.
Fortunately, the clinical lab executives are not alone. The Office of
By Robert Michel, from the Volume XXIII, No. 16 - November 28, 2016 issue
CEO SUMMARY: Clinical lab executives and experts who have studied the final rule for PAMA lab test market price reporting are seriously concerned that the design of this rule may put many of the nation’s smallest, but still essential, clinical labs at great risk of financial distress, if not outright failure. In this exclusive analysis,
By Joseph Burns, from the Volume XXIII No. 15 - November 7, 2016 issue
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 by the Office of the Inspector General makes it possible to estimate how CMS may implement fee cuts in 2018. THE DARK REPORT’s calculations show that a 10%
