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Texas Lawmakers Asked to Stop UHC and BeaconLBS

CEO SUMMARY: In a letter to the Texas Legislature, 20 Texas medical societies say UnitedHealthcare’s BeaconLBS program would be detrimental to patient care. The Texas Medical Association and the Texas Society of Pathologists said they were concerned that the program increases the admini…

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Health Insurers Want More Data On Clinical Utility of Molecular, Genetic Tests

CEO SUMMARY: Genetic tests that lack two essentials are troublesome for the nation’s health insurers. Those essentials are clinical validity and clinical utility. During a recent webinar, two executives from major health insurers stressed the need for genetic testing labs to provide acc…

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PeaceHealth Outreach Laboratory Sells to Quest Diagnostics

This is an excerpt from a 1,471-word article in the February 21, 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…

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PAMA Data Projections Led to Decision to Sell Lab

CEO SUMMARY: Following passage of the Protecting Access to Medicare Act of 2014, officials at PeaceHealth and PeaceHealth Laboratories began to model the financial effect this law would have on this long-established hospital lab outreach program. Based on projections of a 20% cut in reven…

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In Texas, BeaconLBS Start Will Be Delayed

CEO SUMMARY: UnitedHealthcare will not implement the claims impact part of its laboratory benefit management program in Texas on March 1, 2017, as it had previously announced. Opposition to the program and the requirement that physicians use the BeaconLBS system when ordering about 79 lab…

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Health System Lab Is Genotyping To Identify Best Drugs for Patients

CEO SUMMARY: One essential element of precision medicine will be the regular use of pharmacogenomic testing to provide additional guidance to physicians when selecting the most appropriate therapeutics and optimal dose for each individual patient. Despite the reluctance of private payers …

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Theranos Lays Off More Staff, Voids More Lab Test Results

ONCE AGAIN, the controversial lab testing company, Theranos, Inc., found itself the subject of negative news stories. In recent weeks, The Wall Street Journal reported that the beleaguered lab testing company in Palo Alto, Calif., laid off 155 staffers, voided more laboratory test results, a…

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In Texas, Questions for UnitedHealth, BeaconLBS

CEO SUMMARY: As of January 1, 2017, clinical laboratories and pathology groups in Texas will find it more difficult to serve the 500,000 patients enrolled in UnitedHealthcare’s fully-insured commercial plans in the Lone Star State. That’s because—just as it did in Florida—UnitedHe…

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Much Disruption for Labs In 2016’s Top 10 Stories

CEO SUMMARY: Within THE DARK REPORT’S list of the Top 10 Lab Industry Stories for 2016 is one story of disruption that might have been one story of disruption about to happen. The disintegration of Theranos during 2016 is the big story about a self-proclaimed disruptor of the lab indust…

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XIFIN Analysis of Its Real Price Data Shows Hospital Lab Price Effect

CEO SUMMARY: In a new analysis of data its lab clients will use to report market prices to CMS, XIFIN Inc., reports private payers paid independent labs a weighted average price that was 19.6% less than what Medicare pays for 20 of its highest-volume tests. By contrast, private payers pa…

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