TAG:
lab intelligence
Lab Data Crucial to Insurer Risk Adjustment Models
CEO SUMMARY: Payers who use risk adjustment models as part of Medicare Advantage need diagnostic data that helps them document ICD-10 diagnoses that earn them higher premium payments for sicker pat…
Guerrilla Kaizen Events Bring Rapid Change and Cost Savings
CEO SUMMARY: Lean Six Sigma principles are familiar to clinical laboratory and pathology leaders. But a lesser-known offshoot called “guerrilla Kaizen” aims to rapidly identify inefficiencies an…
With Z-codes, Will Other Payers Follow UnitedHealthcare’s Lead?
EDITOR’S NOT…
Technical Assessment Challenges for Z-Code Applications
CEO SUMMARY: Effective on Aug. 1, UnitedHealthcare will require Z-code submissions for many genetic tests. During a recent webinar, experts tackled a topic that may prove troublesome for labs seeking Z-codes: technical assessments. Key advice is to provide specific data about clin…
Optum and Avalon Discuss Genetic Test Claims Review
CEO SUMMARY: With the ever-increasing number of genetic tests on the market, payers are understandably frustrated with genetic test claims that don’t clearly outline the medical need for a procedure or it…
UHC’s Z-Code Requirement to Commence on Aug. 1
CEO SUMMARY: In what may be an alarming development for certain clinical laboratories, as of Aug. 1, UnitedHealthcare will require Z-codes for molecular test claims filed under its co…
Major Events on Horizon to Reshape Lab Market
CEO SUMMARY: Speakers at last month’s Executive War College discussed a range of significant trends and changes happening today in the U.S. healthcare system. Two of the most important trends are …
Pharmacogenetic Tests Deliver for Avera Health Lab
CEO SUMMARY: When Avera Institute for Human Genetics wanted to expand its genomics program, it used its past learning with pharmacogenetics to guide the effort. Two key insights? Ask physicians abo…
Laboratories Can Find Value in Use of Leftover Samples
CEO SUMMARY: After testing on behalf of patients, there are often leftover samples. One company developed a platform to enable life science customers to access the samples and associated diagnostic data for research purposes. For clinical labs, the leftover samples provide an opport…
Sanford Health to Merge with Fairview Health Services
CEO SUMMARY: It’s the latest example of a merger involving two big integrated delivery networks (IDNs). Sanford Health in South Dakota inked an agreement to merge with Fairview Health Services in Minneapolis. This deal confirms the growing trend of consolidation among multi-hospit…
CURRENT ISSUE
Volume XXXI, No. 5 – April 8, 2024
The fragmentation of consumer markets is reflected in clinical lab services, and The Dark Report examines this trend and how it will impact labs in the coming years. Also, The Dark Report notes that the FDA has issued a controversial memo to reclassify many high-risk IVD assays.
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