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lab costs

Health Insurers See Big Increase in Lab Utilization

CEO SUMMARY: In a recent public workshop, managed care executives revealed that the annual cost of outpatient laboratory testing is increasing at twice the rate of all other medical services. One big driver in the increased spending on lab testing is increased utilization…

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Aetna To Lower Lab Test Prices, New Fees Are Effective on July 1

IN RECENT MONTHS, labs are reporting the receipt of letters from Aetna, Inc., announcing that it will pay dramatically less than Medicare prices for many key lab tests. Aetna said that these lower prices will take effect on July 1, 2013. Three examples illustrate the deep fee cuts t…

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Payers Bolix MDx Codes, Labs Unpaid for Months

CEO SUMMARY: Clinical laboratories complain that implementation of a new payment system for molecular tests has been a disaster since January 1. Most contractors for the federal Centers for Medicare & Medicaid Services have not paid labs for molecular tests billed thi…

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Lawyers Share Insights about ACO Contracting

CEO SUMMARY: Most pathologists have yet to be involved in any substantial contractual negotiations that would allow them to assume a significant role in accountable care organizations (ACOs). Instead, hospitals and health systems are putting the building blocks in place by acquiring physi…

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Intermountain Seeks Shared Accountability

CEO SUMMARY: Intermountain Healthcare is one of the nation’s largest and most respected institutions. Its quality improvement efforts are well documented. Intermountain is pursuing an ambitious goal to limit cost increases to the rate of inflation. To reach this goal, every clinical dep…

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Well-Funded Buyers Put Hospital Labs in Bull’s-Eye

CEO SUMMARY: In less than 12 months, two big private equity firms have each launched a lab company with the goal of acquiring and/or managing the clinical labs of hospitals and health systems. In the case of aLabs, it has signed one laboratory management services contract with Aurora and …

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Using Accurate Data to Grow Lab Outreach

CEO SUMMARY: In recent years, the laboratory outreach program at the Robert Wood Johnson University Hospital in New Brunswick, New Jersey, has achieved impressive rates of growth in specimen volume and net revenue. One reason for this success is that the lab outreach program moni…

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How One Akron Physician Helped Uninsured Patients

CEO SUMMARY: For one primary care physician, treating uninsured and underinsured patients was challenging, since these patients could not afford to pay for the lab tests necessary for their healthcare. This physician enlisted the help of his local county medical society and eventually fou…

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Pursuing More Benefits From Next Generation Lab Automation

CEO Summary: Once it was decided to replace an aging, five-year-old laboratory automation system at the laboratory of Ingalls Memorial Hospital in Harvey, Illinois, the administration at the hospital issued a challenge. It asked the laboratory team to deliver an immediate 10% cos…

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Vitamin D Test Volumes Doubled in Past Year

CEO SUMMARY: Across the nation, labs report a near doubling in the volume of vitamin D tests they are performing. This is a success for laboratory medicine and an appropriate use of diagnostics tests as physicians strive for early detection and early intervention of vitamin D deficiency. …

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