There’s bad news for clinical labs and pathology groups that lack the capability of collecting copays, deductibles, and out-of-pocket payments from patients at time of service. As of October, 2016, four out of every 10 Americans under the age of 65 with health insurance had a high-deductible health plan. That means these patients are responsible
Tag: lab test cost
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 industry that finds itself struggling just
CEO SUMMARY: Expanded use of reference pricing by employers in coming years could trigger a cycle of cuts to lab test prices that would put the most pressure on the lab companies with the highest prices. Many hospital labs are viewed as having high prices. But because they run outreach specimens in the evenings and
CEO SUMMARY: There is always a story behind the story, and THE DARK REPORT went to the lead researcher of the reference pricing study published in JAMA Internal Medicine to get it. In this interview, James C. Robinson, PhD, of the University of California, Berkeley, discusses how the findings of his team’s study may encourage
This is an excerpt from a 1,600-word article in the September 6 issue of THE DARK REPORT. The complete article is available to paid members of the Dark Intelligence Group.
CEO SUMMARY: It’s the newest threat to clinical lab survival. A new study shows exactly how reference pricing in healthcare is likely to work, as widely
CEO SUMMARY: Health insurers appear to have stepped up their efforts to warn clinical laboratories not to waive patients’ fees in return for specimen referrals. Consultants also say that payers are increasing enforcement efforts. There are cases where, when insurers discover labs have not collected fees from patients, they have hit labs with automatic payment
CEO SUMMARY: In California, a gene testing firm is increasing satisfaction among patients and physicians with a tool that provides patients with an estimate of the anticipated cost—before the physician orders a test! By providing transparency about the cost of tests upfront, Counsyl of South San Francisco increased revenue collected from patients by 63%, while also improving its customer satisfaction scores. This innovative online cost estimator tool is an example of how labs can deliver services that complement their lab tests and help them move “from volume to value.”
THERE HAS BEEN EXPLOSIVE GROWTH IN THE NUMBER OF PATIENTS enrolled in high- deductible health plans. Currently, more than 20 million people have HDHPs. This is one reason why many labs are experiencing high levels of patient bad debt never before seen by the lab industry during the past three decades.
CEO SUMMARY: Across the nation, hospital administrators are recogniz- ing that effective lab test utilization is a critical factor in a lab’s success. At Seattle Children’s Hospital, clinical pathologists, clinical chemists, and labora- tory genetic counselors are using an innovative utilization management pro- gram to ensure the appropriate use of genetic and molecular tests. They also formed Pediatric Laboratory Utilization Guidance Services. In two years, PLUGS has gained 32 members, including seven hospital labs serving adults. Interest in utilization management is driven by a desire to decrease test order- ing errors and to control the cost of send-out tests.
CEO SUMMARY: In a letter to UnitedHealthcare, the Florida Society of Pathologists says UHC’s pilot laboratory management program will have a negative effect on patient care by delaying access to care and timely diagnoses of disease. Signed by more than 120 members of the society, the letter lays out inconsistencies in the requirements of UHC’s pilot program that Florida physicians must follow to obtain pre-notification or pre-authorization for more than 80 clinical laboratory tests.