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managed care contracting

Labs Wary of BeaconLBS, Express Major Concerns

CEO SUMMARY: Lab executives asked to join UnitedHealth’s new BeaconLBS lab benefit management system soon to launch in Florida have multiple and serious concerns. The primary issue is that BeaconLBS is a subsidiary of LabCorp—their major competitor. These executives understand why a p…

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Survival Essentials for Local Labs

IF THERE IS ANY SINGLE SIGN OF TOUGH TIMES FOR LOCAL LABS, it is decreasing access to patients due to the exclusionary contracting tactic of health insurers. That tactic is the …

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Excluding Lab Competitors Helps Big Labs Grab Greater Market Share

CEO SUMMARY: Changes in healthcare are motivating health insurers and the nation’s largest lab testing companies to enter into contracts in which the large lab company lowers its lab test prices to the payer in return for having the payer exclude that lab company’s toughest competitor…

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Pathology Consolidation Underway in Washington

CEO SUMMARY: Two regional pathology super-practices have emerged in Washington State. In each case, acquisitions and mergers are fueling the growth of the two large pathology groups. In Western Washington and the Seattle metro, CellNetix is the dominant pathology group, with 53 physicians…

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Lab Serving Large MD Group Manages Quality and Costs

 CEO SUMMARY: For decades, pathologists have pointed out that their expertise in laboratory medicine can be tapped by physicians to improve utilization of lab tests, contribute to improved patient outcomes, and reduce the overall cost of care. Exactly that is now happening at Atrius Heal…

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Labs, Path Groups Face Major Financial Issues

CEO SUMMARY: Are clinical labs and pathology groups ready for the end of fee-for-service reimbursement? That’s just one important question that will be answered at the upcoming Executive War College on Lab and Pathology Management that will take place in New Orleans on April 29-30. The …

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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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Anticipating 2013 Trends in Clinical Lab and Pathology

CEO SUMMARY: Biggest news for 2013 will the impact of significant price cuts for both clinical lab and anatomic pathology testing services. But the bad news doesn’t stop there. Employers and private payers will be more aggressive in taking steps to reduce what they spend on lab testing….

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Preserving Competition Is Goal of California Lawsuit

CEO SUMMARY: Once again, the use of deeply-discounted lab test pricing to win exclusive managed care contracts is involved in a court case. However, this latest private lawsuit is different from earlier cases because it seeks to preserve competition in the lab testing and the managed care…

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2012’s Top Ten Lab Stories Predict More Challenges

CEO SUMMARY: It’s been a year with more lows than highs, when viewed through the lens of THE DARK REPORT’S “Top Ten Lab Stories of 2012.” The end of the TC grandfather clause, new policies for prostate biopsy billing, and a dramatic 52% cut to 88305- TC fees were widely reported. …

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