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What Labs Can Expect from PAMA in 2019

CEO SUMMARY: Attendees at the Executive War College learned that CMS has taken steps to expand the number of hospital labs required to report their private payer lab test price data under the Protecting Access to Medicare Act, but the unbundling of certain test panels could be problematic…

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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…

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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…

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Labs Get High Denial Rates Under New NCCI Rules

CEO SUMMARY: Under guidelines the National Correct Coding Initiative issued last year, many clinical laboratories are not getting paid for some tests. The rates of denial for labs running mostly molecular tests could range from 40% to 100% of revenue, one billing expert said. Implemented …

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Reacting to PAMA Cuts, Lab Works with Payers

CEO SUMMARY: Before Medicare’s lab test price cuts went into effect last year, Health Network Laboratories began discussions with private health insurers and nursing home clients about the possibility of renegotiating their contracts. In these discussions, HNL promoted the value it deli…

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April 8, 2019 Intelligence: Late Breaking Lab News

BeaconLBS announced a collaboration with MagnaCare of Garden City, N.Y., last month. The press release issued by the two companies stated that MagnaCare would use the “BeaconLBS Physician Decision Support (PDS) solution with its network of physician and laboratory…

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LabCorp to Acquire Iowa’s Metropolitan Medical Lab

CEO SUMMARY: Without making an announcement, LabCorp said it would acquire the Metropolitan Medical Laboratory, a privately-held laboratory founded in 1914 in Davenport, Iowa. The local newspaper reported that some 136 employees from Metro Medical’s laboratory operations in Moline, Ill….

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February 25, 2019 Intelligence: Late Breaking Lab News

Quest Diagnostics sold its clinical laboratory business in India last December, thus ending a 12-year effort to build a thriving business in that nation of 1.3 billion people. The buyer was Strand Life Sciences of Bengaluru, India. The transaction was announced in a…

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Critical Lessons for Labs That Report PAMA Medicare Data

This is an excerpt from a 1,565-word article in the Feb.4 issue of THE DARK REPORT. The full article is available to paid members of The Dark Intelligence Group. CEO SUMMARY: With most hospitals now included as “applicable laboratories” in the PA…

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Lower Prices, More Data in UHC’s New Lab Network?

CEO SUMMARY: It’s been a common strategy among managed care payers to seek the lowest prices for clinical laboratory testing when negotiating contracts with labs. However, lower prices may become less important over time as the health system moves away from fee-for-service payment towar…

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