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Financial Hurricane Hits Entire Lab Testing Industry

FOR ABOUT 18 MONTHS NOW, THE ENTIRE LABORATORY TESTING INDUSTRY has been hit by an ongoing series of painful cuts to lab test fees and announcements of more restrictive coverage guidelines. Even today, there is additional news of rock bottom prices to share with you. In this issue, you’ll read abo…

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Health Insurers See Big Increase in Lab Utilization

CEO SUMMARY: In a recent public workshop, managed care executives revealed that the annual cost of outpatient laboratory testing is increasing at twice the rate of all other medical services. One big driver in the increased spending on lab testing is increased utilization…

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Aetna To Lower Lab Test Prices, New Fees Are Effective on July 1

IN RECENT MONTHS, labs are reporting the receipt of letters from Aetna, Inc., announcing that it will pay dramatically less than Medicare prices for many key lab tests. Aetna said that these lower prices will take effect on July 1, 2013. Three examples illustrate the deep fee cuts t…

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Dartmouth Builds New Lab to Serve Growth in Testing

CEO SUMMARY: Demand for specialized reference and esoteric testing is so robust at Dartmouth Hitchcock Medical Center in New Hampshire that the academic center is building an expanded laboratory facility to accommodate the increased volume of tests it handles each year. A favorable trend …

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Unpaid for Molecular Tests, Some Labs Are Closing

THERE IS GREAT FRUSTRATION ACROSS THE LABORATORY MEDICINE PROFESSION on the subject of getting paid for claims covered by the new Tier I and Tier II molecular test CPT codes. We are now in the fifth month of the year and pathologists are still waiting for an acceptable resolution to this situation. …

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Executive War College Sessions Center Upon Three Trends

CEO SUMMARY: There was an interesting blend of anxiety and optimism as a record crowd gathered in New Orleans last week for the 18th annual Executive War College on Laboratory and Pathology Management. The anxiety was rooted in the shrinking prices paid by payers for lab testing services….

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Medicare Taken to Task about Molecular Test Pricing Method

EDITOR’S NOTE: Submitted by Lâle White, CEO of XIFIN, Inc., of Carlsbad, California, this letter describes the problems caused by the Medicare program’s failure, as of January 1, 2013, to be ready to process and reimburse lab test claims for more than 100 new mo…

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Mass Spectrometry Is Finding Larger Role in Clinical Labs

CEO SUMMARY: Mass spectrometry is a diagnostic technology that is transforming clinical labs and improving care at a rapid pace. The current generation of instruments is capable of supporting a faster time-to-answer and provides improved accuracy and specificity over many existing methods…

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Anticipating Washington’s Next Blows to Lab Testing

CEO SUMMARY: With the advent of 2013, almost every lab was responding to some type of price cut. Clinical labs are dealing with the sequential, multi-year cuts to the Medicare Part B Lab Test Price Schedule. Anatomic pathology labs are still adjusting to the expiration of the TC Grandfath…

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ACO Numbers Increase, Now Cover 10% of Nation

CEO SUMMARY: A recent report by a consulting firm that tracks the ACO industry indicates that, as of the end of 2012, ACOs of all types involved—in some manner—between 25 and 31 million patients. Moreover, Medicare and private ACOs are located in regions where 45% of the population of…

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