TWO MAJOR, DISRUPTIVE CHANGES lie ahead for both clinical laboratories and anatomic pathology group practices. Each disruptive factor has nothing to do with how payers select in-network labs or reimburse for lab testing services.
Rather, one of these two major changes involves fundamental advances in the diagnostic technologies used by labs to diagnose disease and guide
DEEP PRICE CUTS to the Medicare Part B Clinical Laboratory Fee Schedule was the big story of 2017. The big story of 2018 may be the widespread financial disruption to the clinical lab industry as labs see dramatic declines in their revenue from these Medicare fee cuts.
One early opportunity for lab administrators and pathologists to
This is an excerpt from an 850-word article in the May 15, 2017, 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: There are few places and times where a broad cross-section of
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
CEO SUMMARY: Pre-authorization of genetic tests is coming to physicians serving patients insured by Anthem, Inc. Its specialty benefits management company, AIM Specialty Health, will manage the program. AIM will work with InformedDNA, a company that specializes in genetic testing clinical decision support and genetic counseling for health insurers. Anthem has about 40 million members
INNOVATIVE CLINICAL LABS are making significant changes to accommodate the shift from volume to values. In one change, they are collaborating with clinicians to use lab test data to improve patient outcomes.
In another, they are collecting the clinical data from these efforts to publish the outcomes in peer-reviewed medical journals to spread the word about
CEO SUMMARY: By now, there is widespread recognition among pathologists and clinical lab managers that the era of fee-for-service reimbursement is giving way to new forms of payment that reward value. First-mover lab leaders are in the earliest stages of developing enhanced lab testing services that contribute to improved patient outcomes while reducing costs. These
CEO SUMMARY: Moving away from volume-based care will not be easy for clinical labs. After all, high volume sustains labs. But labs seeking to transition away from fee-for-service to value-based care must have a seat at the table where decisions are made, said a lab CEO who is part of Project Santa Fe, which wants
CEO SUMMARY: Among the major themes to emerge from the more than 60 sessions and 100 speakers at this year’s Executive War College on Lab and Pathology Management were the accelerating pace of integrated care, the growth of precision medicine, and use of big data to guide physicians. Other issues centered on labs’ need to