CEO SUMMARY: Court documents filed in U.S. District courts in New Jersey and North Carolina provide details about how each of the two lab companies set lab test prices differently—as much as 10 times higher—for cash-paying patients than for patients who have Medicare, Medicaid, or commercial health insurance plans. In court filings, plaintiffs allege that
Tag: labcorp and quest
CEO SUMMARY: In Florida, the Blue Cross Blue Shield contract is coming up for renewal and the question is whether it will renew as exclusive to one national lab company. But Florida is not the only state where BCBS plans are planning to issue new contracts. Among the Blues plans that may ask for proposals
This is an excerpt from a 1,500-word article in the Feb. 25, 2019 issue of THE DARK REPORT. The full article is available to members of The Dark Intelligence Group.
CEO SUMMARY: In their respective earnings reports for the fourth quarter and the full year of 2018, executives at both Laboratory Corporation of America and Quest
This story was updated from the original on March 27, 2019, and includes corrected information in three places.
CEO SUMMARY: In their respective earnings reports for the fourth quarter and the full year of 2018, executives at both Laboratory Corporation of America and Quest Diagnostics told financial analysts that the Medicare fee cuts of 2017 and
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
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,
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
CEO SUMMARY: By cutting out smaller, regional labs, UnitedHealthcare appears to want to shift an unknown percentage of its lab test volume to Quest Diagnostics Inc., which it recently restored to its national provider network. Clinical lab directors should be concerned about this development because UHC is the nation’s largest health insurer and because other
CEO SUMMARY: New national lab contracts that LabCorp and Quest announced in May could disrupt the lab testing market in ways regional labs can exploit, experts said. Health plans entered these new contracts after realizing that the exclusive network contracts do not work, one lab consultant explained, adding that large national labs will compete with
RECENTLY TWO OF THE NATION’S LARGEST HEALTH INSURERS abandoned a managed care contracting strategy that they adopted 11 years ago. Back in 2007, UnitedHealthcare and Aetna each were willing to grant exclusive national provider status to a single lab company in exchange for deeply-discounted lab best prices. (See TDRs, Oct. 16, 2006, Feb. 19, 2007, and