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lab test pricing

How Northwell’s Lab Team Demonstrated Value Over 10 Years

CEO SUMMARY: Among hospital administrators, the popular wisdom is that their clinical lab is a cost center. This thinking leads them to consider drastic cost-management strategies that include partnering with commercial labs to manage in-hospital lab testing and the outright sale of lab o…

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Why It Matters That Your Lab Has Low Test Prices

TODAY, THE LAB INDUSTRY FACES A CONTRADICTION when setting prices for individual lab tests. At one extreme, a certain sector of labs seeking to win exclusive managed care contracts sets high-volume routine test prices at or below the fully-loaded cost to perform those tests. At another extreme, labor…

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Gene Testing Lab Goes ‘Cold Turkey,’ Stops Billing Health Plans

CEO SUMMARY: Last year, Kailos Genetics stopped collecting third-party payment, dropped its prices sharply, and started marketing its genetic-screening tests directly to consumers and physicians. At the time, 100% of its revenue came from third-party payers. Today, it gets 100% of its rev…

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Lab Briefs

QUEST SETTLES TEST-PRICING CASE WITH FOUR CALIFORNIA LABS LAST WEEK, A CALIFORNIA JUDGE APPROVED the settlement of a lawsuit that claimed Quest Diagnostics Incorporated had violated a state law that forbids selling services (in this case, lab testing) below cost. In a deci…

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How Price Transparency Increased Lab’s Revenue

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, Co…

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Philly Blue Cross Contract: LabCorp In; Quest Out

CEO SUMMARY: Independence Blue Cross in Philadelphia decided to select Laboratory Corporation of America for its new eight-year managed care contract that took effect on July 1. However, the real story is the aggressive bidding war between the two national labs. Sources say LabCorp bid an…

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At Mid-Year, Labs Struggle to Get Paid for Many Tests

CEO SUMMARY: At a recent coding and billing conference, pathology and lab clients of one of the nation’s largest revenue management companies agreed that three trends have caused lower revenues since the start of 2014. One trend seen by labs involves higher deductibles and copayments fr…

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Congress’ New SGR Law Has Mixed News for Labs

CEO SUMMARY: Once again, the lab industry faces a mixed bag following passage of a new law by Congress last week. Besides the one-year fix for the SGR, H.R. 4302 also has language that may defer adjustments to Medicare Part B lab test fees until 2017 and creates a new procedure for Medica…

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Federal Judge Lets Trial Proceed in Case against Quest

CEO SUMMARY: Four California labs have charged that Quest Diagnostics engaged in predatory pricing in a case filed originally in November 2012. After the lawsuit was amended last summer and fall, U.S. District Judge William H. Orrick III heard various motions in the case. On February 6 he…

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Scrutinizing the Cost of Lab Testing

IT SEEMS LIKE THE COST OF LABORATORY TESTING continues to be a high-profile issue. On the pages that follow, you will read two different stories about how the cost of lab testing is undergoing intense scrutiny. This is not an accident. Rather, it shows how healthcare’s evolution is already undermin…

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