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lab test utilization

Issues Encountered with Anthem’s Pre-approval

CEO SUMMARY: Since Anthem and AIM Specialty Health began a prior-authorization program for genetic testing July 1, a Northeast lab has not had any genetic tests approved through the new system. Physicians told the lab that the steps required for prior authorization were disruptive. Those …

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In Texas, BeaconLBS Start Will Be Delayed

CEO SUMMARY: UnitedHealthcare will not implement the claims impact part of its laboratory benefit management program in Texas on March 1, 2017, as it had previously announced. Opposition to the program and the requirement that physicians use the BeaconLBS system when ordering about 79 lab…

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Why Lab Prices Declined 32% During 3-Year Study

CEO SUMMARY: Researchers studied the effect reference pricing had on an employer’s efforts to steer consumers to low-cost clinical labs. The study showed that patients were particularly sensitive to lab test prices—in part because those prices varied widely. Over the course of the …

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July 5, 2016 Intelligence: Late Breaking Lab News

More developments have happened at Theranos, Inc., the beleaguered clinical lab company based in Palo Alto, California. On June 24, Brook Buchanan, Vice President of Communications at Theranos, resigned, giving personal reasons for the decision. Buchanan was hired in November 2015, …

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Lab CEO Sees Three Trends Cutting Volume, Revenue

CEO SUMMARY: Following the sale of his hospital lab outreach business to a national lab company, former CEO James Fantus told THE DARK REPORT about the significant trends he saw unfolding in the Northeast. They include: a shrinking number of physician customers for labs; a rising number o…

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2015’s Top 10 Lab Stories Show Significant Changes

CEO SUMMARY: During 2015, two stories captured the full attention of most pathologists and clinical lab managers. One was how CMS intends to gather lab price market data as mandated by PAMA. The other was the continued efforts by the FDA to move ahead on proposed guidance for regulation o…

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State of Clinical Lab Industry Likely to Be Mixed in 2016

CEO SUMMARY: Over the next 24 months, it will be essential for every clinical laboratory and anatomic pathology group to develop clinical and financial strategies that meet the changing needs of health insurers, hospitals and health systems, physicians, and patients. THE DARK REPORT provi…

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Hospital Lab Shares Ten Ways to Create Value with Lab Tests

CEO SUMMARY: Across the nation, labs in hospitals and health systems are feeling pressure from shrinking lab budgets and the need to be a contributor to the integration of clinical care. At Henry Ford Health System in Detroit, the clinical laboratory and department of pathology have respo…

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Lab Test Utilization Delivers Big Gains at Cleveland Clinic

CEO SUMMARY: Since the launch of a laboratory test utilization program in 2011 at the Cleveland Clinic, more than 35,000 duplicate or inappropriate test orders have been stopped. The test utilization team introduced five initiatives that are not designed to cut spending but to in…

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Some Florida Docs Are Not Using BeaconLBS System

CEO SUMMARY: Some physicians in Florida are not complying with UnitedHealthcare’s laboratory benefit management program since the claims impact took effect on April 15. Although officials from UnitedHealthcare and BeaconLBS, a business division of LabCorp, state publicly that the…

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