Tag: Esoteric testing

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Esoteric testing allows the analysis of rare substances or molecules that are not performed in a routine clinical lab. Many large commercial lab companies outsource complex tests to reference and esoteric testing labs. However, as technology continues to expand laboratory testing, tests that are considered esoteric today may become routine in just a few years. This is often the result of work performed by dedicated research and development scientists.

These tests are ordered when a physician requires additional detailed information, outside routine lab testing, to complete a diagnosis, establish a prognosis or choose and monitor a therapeutic regimen. Esoteric testing generally requires sophisticated instruments and materials as well as specialized personnel to perform and analyze results. The tests are typically outsourced to independent, specialized clinical reference laboratories because it is not cost effective for hospitals and physician office laboratories to perform the tests in-house.

These tests are ordered less frequently than routine tests and are generally priced higher than the routine tests. Esoteric testing is typically related to the medical fields such as endocrinology, genetics, immunology, microbiology, molecular diagnostics, oncology, serology and toxicology. Molecular diagnostics is the fastest growing segment of esoteric clinical testing.

The American Chemical Society publishes the Directory of Rare Analyses (DORA) which catalogues rarely ordered clinical tests and provides details on the labs performing them.

The challenges for labs performing such tests include not only finding qualified medical technologists, but also paying them the higher salaries they command because of the scarcity of their skill sets. In addition, materials used in these tests can also be costly, particularly because they are not usually purchased in large enough quantities to qualify for economies of scale.

Labs that perform these tests have capabilities including:

• Allergy
• Complex anatomic pathology with board-certified pathologist
• Bone markers
• Genetic analysis
• HLA testing
• Functional assays of the immune system
• Toxicology

In the U.S., labs that perform these tests range from ARUP Laboratories, Mayo Medical Laboratories, Quest Diagnostics Incorporated, and Laboratory Corporation of America to a growing number of specialty esoteric testing laboratories that offer proprietary esoteric assays. Examples of such specialty testing lab companies include Myriad Genetics, Genomic Health, and Foundation Medicine.

NYU Langone and Sonic Healthcare Create Laboratory Outreach Joint Venture

CEO SUMMARY: NYU Langone Health recognized the clinical and financial advantages of providing competitive lab outreach testing services to its employed physicians. The laboratory joint venture with Sonic Healthcare USA will allow NYU Langone to increase use of its hospital labs and will facilitate standardizing its testing methods, results, and reference ranges. The first phase

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Value-Based Care Is One Goal Of WHCN-Sonic Lab JV

CEO SUMMARY: Announced last month, the new laboratory joint-venture partnership with Sonic Healthcare’s Sunrise Clinical Laboratories will allow WCHN to compete with other health systems and prepare to respond to health insurers’ requests that hospital systems offer lower rates in value-based payment models. WCHN has already seen payers shift to low-cost providers. For this reason,

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Mayo Medical Laboratories Will Close Massachusetts Lab

IN AN ANNOUNCEMENT MADE LAST MONTH, Mayo Medical Laboratories said that it would close the lab facility it operates in Andover, Massachusetts, by the end of the year.

As a result of this move, Mayo will eliminate 105 jobs in this leafy suburb north of Boston. For 20 years, MML has operated the lab in Andover, its only facility in New England.

News outlets reported

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State of Clinical Lab Industry Likely to Be Mixed in 2016

CEO SUMMARY: Over the next 24 months, it will be essential for every clinical laboratory and anatomic pathology group to develop clinical and financial strategies that meet the changing needs of health insurers, hospitals and health systems, physicians, and patients. THE DARK REPORT provides its assessment of key macro trends for 2016, along with comments

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Opko Pays $1.47 Billion to Buy Bio-Reference Lab

CEO SUMMARY: It’s a case of the little fish gobbling the big fish, as Opko Health—with revenue of $91 million—will be acquiring Bio-Reference Laboratories, with revenue of $832 million. But the more interesting aspect of the story is that the CEO of Opko Health is a physician worth $5 billion and highly respected by Wall Street. It could be that Bio-Reference CEO Marc Grodman, M.D., has gained a shrewd advisor and powerful ally in Phillip Frost, M.D., the Chair and CEO of Opko Health.

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Early ACO Experience Has Lessons for Pathologists

CEO SUMMARY: To date, many of the nation’s 500 accountable care organizations have launched with little involvement by independent pathology groups and clinical laboratories. That was not the case with an ACO in Alabama, however. From its inception in 2012, the ACO has contracted with CytoPath, P.C., a five-pathologist group in Alabaster, Alabama. CytoPath’s pathologists are currently paid on a fee-for-service basis and must provide detailed and timely data to the ACO.

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Is PAML to Be Sold? ‘No Comment!’ Say Execs

CEO SUMMARY: It is one of the 10 largest lab companies in the United States. Thus, if Pathology Associates Medical Laboratories in Spokane, Washington, were to be sold, it would trigger a major shift in the competitive market for lab testing services-both in the Pacific Northwest and nationally. Owners and executives at PAML have neither confirmed nor denied the ongoing rumors

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