TAG:
lab test
In New Mexico, Three Collaborators Improve Patient Care, Outcomes
IT’S OFFICIAL! A YEAR-LONG COLLABORATION involving a health insurer, a clinical laboratory, and an analytics company showed that insurers and physicians can use clinically-actionable intelligence developed from medical lab test data to improve patient outcomes. This important accomplishment in patie…
After Two-Year Battle with CMS, True Health on Verge of Collapse
CEO SUMMARY: In 2017, an auditor for CMS alleged that True Health filed fraudulent claims and the federal Medicare program cut all payments to the lab company and one month later reduced the cut to 35% of the billed amount. Two months ago, CMS ended all payments again. These facts became …
After Two-Year Battle with CMS, True Health Diagnostics on Verge of Collapse
This is a synopsis of three in-depth articles in the Aug. 12, 2019 issue of THE DARK REPORT (TDR). The full articles are available to members of The Dark Intelligence Group. CEO SUMMARY: In 2017, an auditor for CMS alleged that True Health Diagnostics f…
Bill Would Delay PAMA Reporting for One Year
CEO SUMMARY: For all laboratories that must report private payer price data under the Protecting Access to Medicare Act (PAMA), a new bill in congress would delay the next round of data reporting for one year and require the National Academy of Medicine to recommend ways to improve the da…
Four Insurers, Quest Developing Blockchain
CEO SUMMARY: Organizations developing blockchain technology say it is a tamper-proof method of sharing data across networks and among providers, health insurers, and health systems. The Synaptic Health Alliance includes four of the largest health insurers, a health network, and Quest Diag…
Aetna, Anthem to Pay Pathology Groups Less
TWO OF THE NATION’S LARGER HEALTH INSURERS—AETNA AND ANTHEM— ARE CUTTING WHAT THEY PAY for the professional component of certain clinical and anatomic pathology codes. In its communications with pathology groups about this policy change, Aetna says it will no longer pay for most clinical laborat…
Northwell Health Lab Team Leverages Data to Add Value
CEO SUMMARY: Today, insurers get risk-adjusted payments for treating patients who have high-cost health conditions and they make risk-adjusted payments to physicians, hospitals, and other providers. At Northwell Health, the clinical lab saw the opportunity to leverage lab test data with …
TriCore Forges Ahead to Help Payers Manage Population Health
CEO SUMMARY: To develop new sources of revenue to offset declining fee-for-service payments, TriCore Reference Labs is collaborating with health insurers in novel ways to improve patient outcomes and lower healthcare costs. To achieve this, TriCore brings together data from lab tests, EHR…
TriCore Finds Value-Based Healthcare a Profitable Endeavor
This is an excerpt from a 3,380-word article in the May 20, 2019 issue of THE DARK REPORT. The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: To develop new sources of revenue to offset declining …
The Bad News: Disruption. The Good News: Opportunity!
CEO SUMMARY: There was an interesting consensus that emerged from the 80 sessions and 118 speakers at this year’s Executive War College in New Orleans earlier this month. The consensus centered around two themes. One theme is disruption, which is bad news for those labs that hope to mai…
CURRENT ISSUE
Volume XXXII, No. 14 – October 6, 2025
The Dark Report examines increasing healthcare costs for employers and how clinical labs can help those employers. Also, an in-depth case study shows how one hospital system regained its outreach program after originally ceding it to a national lab company, adding millions to the system’s bottom line.
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