Tag: hedis

TriCore Forges Ahead to Help Payers Manage Population Health

CEO SUMMARY: To develop new sources of revenue to offset declining fee-for-service payments, TriCore Reference Labs is collaborating with health insurers in novel ways to improve patient outcomes and lower healthcare costs. To achieve this, TriCore brings together data from lab tests, EHRs, patient demographics,  and geography. Analytical tools allow it to assess population health

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Florida Doctor Questions Lab Test Pre-notification

CEO SUMMARY: An interesting tug-of-war may develop in Florida between a major health insurer and physicians. UnitedHealthcare will require physicians to obtain a pre-notification number for 81 lab tests by using the BeaconLBS system (developed by a subsidiary of LabCorp). One family practice physician is speaking out about his concerns that the new UHC requirement

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Pre-authorization Coming For Pricey Molecular Tests

CEO SUMMARY: In response to the steep ramp-up in the utilization of genetic and molecular testing, the nation’s largest health insurers are preparing to institute new guidelines for coverage and reimbursement. These will include pre-authorization by physicians, a more effective genetic test coding arrangement for claims submission by laboratories, and implementation of evidence-based medicine (EBM)

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Key Trends Drive Change for Clinical Laboratories

CEO SUMMARY: Technology plays an ever-growing role in reshaping the organization and operation of clinical laboratories. New technologies figure prominently in THE DARK REPORT’S 2007 list of key trends in the clinical laboratory industry. Technological advances in instrument systems, informatics, and molecular diagnostics are giving laboratories new tools to improve clinical services and streamline lab

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LabOne Speaks Out About Use of “Free Testing”

DEAR EDITOR,
In the August 26, 2002 issue of THE DARK REPORT, an article appeared entitled, “Two Blood Brothers Use ‘Free Testing’ Strategy.”

In markets that we are “in-network” with various payers, this tactic of providing free testing is increasingly prevalent. While the competitive injury inflicted on other providers by this questionable practice is obvious, the damage

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“Pay for Performance” Starts For California Docs

CEO SUMMARY: California is a bellwether state for healthcare innovations. Six of its largest payers are collaborating on “Pay For Performance,” a program which pays financial incentives to physician group practices which achieve measurable outcomes in clinical care, patient satisfaction, and implementation of information technology. It’s expected to be a model for similar initiatives in

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