1. CMS Sticks by Decision to Deeply Cut Medicare Part B Lab Test Fees
SHORT OF A MIRACLE, the clinical laboratory industry is less than three weeks from the single most financially-disruptive event of the past 30 years. On Jan. 1, the federal Centers for Medicare and Medicaid Services will impose deep cuts to Part B
CEO SUMMARY: The FDA’s clearance of the first digital pathology system for use in primary diagnosis will be a disruptive force for pathologists in the coming years. At the University of Southern California Keck School of Medicine, pathologist Clive Taylor, MD, predicts that the benefits of whole slide imaging and digital pathology will enable pathologists
CEO SUMMARY: UnitedHealthcare directly tackled the issue of out-of-network labs waiving or capping copayments, coinsurance and deductibles that are to be paid by patients. In a network bulletin this month, UHC said that such arrangements may violate federal law and could lead to state insurance department investigations into false claims. In the same bulletin to
IN RECENT DECADES, A PROPORTION OF PATHOLOGISTS has been proud of the fact that the pathology profession—to a large extent—had managed to protect the vast majority of private pathology group practices from any number of powerful trends and market forces.
In the 1990s, HMO contracting practices triggered a major wave of consolidation of hospitals, primary care
In a milestone for advocates of digital pathology, n anatomic pathology laboratory in The Netherlands has been identified as the first in the world to “transition completely to digital diagnosis.” The laboratory is Laboratorium Pathologie Oost-Nederland (LabPON), located in Hengelo.
CEO SUMMARY: Will 2015 turn out to be a watershed year for the clinical laboratory industry? With healthcare cost solutions continuing to squeeze laboratory profits, two federal agencies are pushing forward with initiatives that will touch nearly every medical lab in the United States in the next 12 months. Other equally powerful trends continue to negatively influence the prices labs are paid for their testing services. All these factors make it essential for lab administrators and pathologist business leaders to work proactively to maintain their lab’s financial stability.
CEO SUMMARY: Will 2015 turn out to be a watershed year for the clinical laboratory industry? Not only are two federal agencies pushing forward with initiatives that will touch nearly every medical lab in the United States in the next 12 months, but other equally powerful trends continue to negatively influence the prices labs are paid for their testing services. All these factors make it essential for lab administrators and pathologist business leaders to work proactively to maintain their lab’s financial stability.
CEO SUMMARY: Across the United States, clinical labs, histology labs, and pathology groups are experiencing both a much longer payment cycle for claims and a decreased gross collection rate. Blame can be placed on several trends. One trend is the steady increase in the number of patients with high-deductible health plans. Another trend involves payers
CEO SUMMARY: Pathologists looking for a viable future in a healthcare system marked by integration of clinical care and value-based reimbursement will be interested to learn about Spectrum Medical Group based in Portland, Maine. This 180-member multispecialist group includes 22 pathologists (but no primary care physicians). It has found a way to serve ACOs, health
CEO SUMMARY: For 2013, the big story was money—or, more accurately, less money for providers. This was not limited to clinical labs and pathology groups, but was equally true of hospitals and physicians. In THE DARK REPORT’S annual lookback at the year’s 10 most important stories for the lab industry, the main theme is that