By Joseph Burns, from the Volume XXVI No. 2 – February 4, 2019 issue
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 toward value-based reimbursement. Now evidence is accumulating that at least some large
By Joseph Burns, from the Volume XXVI No. 2 – February 4, 2019 issue
CEO SUMMARY: It is ironic that, after the federal Centers for Medicare and Medicaid Services (CMS) enacted the deepest price cuts to the Part B Clinical Laboratory Fee Schedule in more than 50 years, a U.S. Senator now asks CMS why it will pay billions more for lab testing. The question from Iowa Senator Chuck
By Mary Van Doren, from the Volume XXVI No. 1 – January 14, 2019 issue
CEO SUMMARY: This will be one of the most challenging years facing the clinical lab industry since the early 1990s. The CMS scheme to collect private payer lab test prices and use that data to set Medicare clinical laboratory test prices is proving to be an indiscriminate tool that is poised to undermine the financial integrity of many labs,
By Joseph Burns, from the Volume XXVI No. 1 – January 14, 2019 issue
CEO SUMMARY: In Toledo, Ohio, ProMedica Laboratories uses extensive metrics to analyze almost all processes in the lab. Under a process improvement program in place for more than five years, the lab has implemented daily management to help streamline day-to-day operations. Concurrently, a newly-formed cross-functional test utilization team adopted recommendations from the Choosing Wisely campaign
By Joseph Burns, from the Volume XXVI No. 1 – January 14, 2019 issue
CEO SUMMARY: With so many market forces working against the economic interests of clinical laboratories, it is essential that all labs develop appropriate strategies designed to sustain the quality of laboratory testing services and the financial integrity of the laboratory organization. In this intelligence briefing, XIFIN, Inc.’s CEO, Lâle White, explains five strategies that are
By Robert Michel, from the Volume XXVI No. 1 – January 14, 2019 issue
CEO SUMMARY: This will be one of the most challenging years facing the clinical lab industry since the early 1990s, when closed panel HMOs were the disruptive force that generated deep cuts in lab test prices. However, unlike HMOs of that era, the CMS scheme to collect private payer lab test prices and use that
By Mary Van Doren, from the Volume XXV No. 18 – December 24, 2018 issue
CEO SUMMARY: This year’s list of the Top 10 Lab Industry Stories for 2018 is dominated by new directives from Medicare and private health insurers, as well as significant decisions by federal courts. Collectively, these developments create new compliance risks for all clinical laboratories and anatomic pathology groups. What is more notable about these top
By Robert Michel, from the Volume XXV No. 18 – December 24, 2018 issue
CEO SUMMARY: This year’s list of the Top 10 Lab Industry Stories for 2018 is dominated by new directives from Medicare and private health insurers, as well as significant decisions by federal courts. Collectively, these developments create new compliance risks for all clinical laboratories and anatomic pathology groups. What is more notable about these top
By R. Lewis Dark, from the Volume XXV No. 18 – December 24, 2018 issue
Each time a new year approaches, it is natural to look ahead and think about what the next 12 months will bring. My bet is that certain sectors of the clinical laboratory industry are soon to experience substantial disruption.
This disruption will come in two forms. First, federal regulators will be tougher on labs that violate
CEO SUMMARY: At the last minute, Congress added all clinical laboratories to a far-reaching provision in the newly-enacted Support for Patients and Communities Act. Unlike the Anti-Kickback Statute, this provision applies to all payers, both government and private, and offers no safe harbors. Lab experts say this new law could turn relatively innocuous and heretofore
