Lower Prices, More Data in UHC’s New Lab Network?

By Joseph Burns | From the Volume XXVI No. 2 – February 4, 2019 Issue

CEO SUMMARY: It’s been a common strategy among managed care payers to seek the lowest prices for clinical laboratory testing when negotiating contracts with labs. However, lower prices may become less important over time as the health system moves away from fee-for-service payment towar…

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CEO Describes Characteristics Of the Clinical Lab 2.0 Model

By Joseph Burns | From the Volume XXIV No. 7 – May 15, 2017 Issue

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 Proj…

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New ADLT Payment Rate May Force Lab to Close

By Joseph Burns | From the Volume XXII No. 15 – October 26, 2015 Issue

CEO SUMMARY: Four Medicare Administrative Contractors currently pay $2,821 for CareDx’s AlloMap test. But under the proposal that CMS issued last month to overhaul the clinical lab fee schedule, CareDx would get only $644. Such a steep price cut would put the lab out of business because…

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New Lab Industry Trends Require Responses by Labs

By Robert Michel | From the Volume XXII NO. 7 – May 11, 2015 Issue

CEO SUMMARY: One stark difference between the presentations delivered at last year’s Executive War College and this year’s presentations in New Orleans last week was near-unanimous recognition that the era of fee-for-service payment is soon to end! Speaker after speaker urged the…

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NorDx CEO Shares Five Rules Critical to every Lab’s Success

By Joseph Burns | From the Volume XXI No. 11 – August 11, 2014 Issue

CEO SUMMARY: To meet the financial challenges of healthcare today, clinical labs and pathology groups can follow the five classic lab rules of success. However, as noted by Stan Schofield, CEO of NorDx Laboratories in Scarborough, Maine, the “old school” methods need …

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Laboratory Offers Early Lessons in Positioning for Success with ACOs

By Joseph Burns | From the Volume XX No. 10 – July 29, 2013 Issue

CEO SUMMARY: Accountable care organizations (ACOs) are already leading the shift from fee-for-service reimbursement to population payment. ACOs are leading healthcare’s evolution to preventive care, wellness, and better management of patients with chronic disease. This evolution will re…

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One Lab’s Revenue Loss Due to CMS’ Slow Process

By Joseph Burns | From the Volume XX No. 5 – April 15, 2013 Issue

CEO SUMMARY: How is it that some commercial payers for one lab running molecular tests have continued to pay the lab for tests it has run this year, but contractors for CMS have so far failed to pay? That’s the question one lab CEO is asking. Both the commercial payers and the CMS contr…

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Another Whistleblower Lawsuit: Why Care?

By R. Lewis Dark | From the Volume XIX No. 3 – February 20, 2012 Issue

IN READING THIS ISSUE, YOU MAY LEARN, FOR THE FIRST TIME, how a former CEO of a public lab has filed two whistleblower lawsuits. His most recent qui tam lawsuit names Laboratory Corporation of America as defendant. The earlier qui tam lawsuit was filed against …

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Former Lab CEO Explains Why He Filed Lawsuit

By Robert Michel | From the Volume XIX No. 3 – February 20, 2012 Issue

CEO SUMMARY: It may be the first time that a former public laboratory CEO has turned whistleblower. Andrew Baker, formerly Chairman and CEO of Unilab Corporation in the 1990s, filed a qui tam case in federal court last year that centers on the practice of lab companies offering private he…

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Final Three Labs Settle California Qui Tam Case

By Joseph Burns | From the Volume XIX No. 1 – January 9, 2012 Issue

CEO SUMMARY: In recent months, the California Attorney General (AG) entered into settlement agreements with the last three defendant laboratory companies involved in the Medi-Cal discount pricing whistleblower lawsuit. The AG did not make this news public. In their respective settlement a…

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