Tag: cost of lab

Lab Benefit Managers Want to Help Health Plans

CEO SUMMARY: Laboratory benefit management companies that offer a range of services to health insurers are gaining influence over clinical lab testing in important ways. On behalf of health insurers, LBMs will select labs for a payer’s network, then manage that network. They also manage claims and lab-test utilization, often reviewing medical necessity. A primary

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Reacting to PAMA Cuts, Lab Works with Payers

CEO SUMMARY: Before Medicare’s lab test price cuts went into effect last year, Health Network Laboratories began discussions with private health insurers and nursing home clients about the possibility of renegotiating their contracts. In these discussions, HNL promoted the value it delivers to health insurers in terms of fast turnaround times, lab-test utilization management, and

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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 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%

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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 labs and pathology groups will need to align their diagnostic services to meet the

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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 study, a grocery chain saved $2.7 million when the percentage of patients using higher-priced labs

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Alert to All Labs: Beware Of ‘Reference Pricing’

CEO SUMMARY: “Reference pricing” does not refer to how a lab negotiates prices with its reference lab! Rather, reference pricing describes a specific approach to health plan benefits that incentivizes the consumer to choose lower-cost providers while allowing that consumer to still use a higher-priced provider, so long as that consumer pays the additional costs

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Ohio State University Medical Center Inks Pact To Adopt Digital Pathology

CEO SUMMARY: For years, the adoption of digital pathology has lagged behind the predictions of its advocates. That has encouraged one digital pathology company—Inspirata, Inc., of Tampa—to come up with a different business strategy designed to help anatomic pathology labs address the barriers and capital costs involved with establishing a digital pathology system. The Ohio

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Newsmaker Interview: Matthew Hawkins

CEO SUMMARY: By now, most pathologists and clinical laboratory administrators recognize that effective use of information technology will be a critical success factor as healthcare systems transform to do population health management and to use “big data” with value-based payment models. As the provider of laboratory information systems to hundreds of the nation’s major hospitals,

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