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managed care organization

Paths of Hospital Labs, Independent Labs Diverge

CEO SUMMARY: With each passing year, the primary role of hospital and health system labs evolves in a different direction than that of independent lab companies. This trend is a response to the creation of integrated delivery networks paid on value and how they are scored on their ability…

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Labs Have Heavy Burden to Report Lab Price Data

CEO SUMMARY: Clinical labs must assess their responsibilities to report lab test market prices to CMS as part of the Protecting Access to Medicare Act. A panel of three experts took up this topic at a recent webinar hosted by THE DARK REPORT. On June 23, the federal Centers for Medicaid &…

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PAMA Final Rule Issued, CMS Plans to Cut Rates by 5.6%

CEO SUMMARY: CMS issued its final rule for implementing the laboratory payment reform included in the Protecting Access to Medicare Act of 2014 (PAMA) on June 17. All labs will see significant reductions to the Medicare Part B Clinical Laboratory Fee Schedule that becomes effective on Jan…

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NeoGenomics to Acquire Clarient for $275 Million

CEO SUMMARY: In a surprise move that further consolidates national anatomic pathology services, NeoGenomics will acquire Clarient Inc., from General Electric Healthcare. General Electric is getting cash, and preferred and common stock. The two companies announced plans to pursue integrate…

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Hospitals Recognize Need for Uniform Lab Test Data

CEO SUMMARY: Hospitals may soon insist that payers allow their in-house labs to provide outpatient testing regardless of exclusive managed care contracts with national lab companies. The migration to accountable care organizations (ACOs) and medical homes makes it essential that physician…

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February 11, 2013 “Intelligence: Late Breaking Lab News”

Would it surprise you to learn that just five organizations control 91% of California’s health insurance market? At the top of the list is Kaiser Permanente, which holds a 40% share of the California market. Following, in order, were Anthem Blue Cross (23%), …

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Payer Trend in New Hampshire Is to Engage Lab Patients

CEO SUMMARY: A health insurer’s two-year-old effort to have patients choose low-cost laboratory testing options is causing patients to shift their lab work away from New Hampshire’s hospitals and instead use Quest Diagnostics, LabCorp, and ConVerge (a commercial lab company). This new…

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Using Accurate Data to Grow Lab Outreach

CEO SUMMARY: In recent years, the laboratory outreach program at the Robert Wood Johnson University Hospital in New Brunswick, New Jersey, has achieved impressive rates of growth in specimen volume and net revenue. One reason for this success is that the lab outreach program moni…

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Piedmont Med Lab Mixes ISO with Lean & Six Sigma

CEO SUMMARY: Piedmont Medical Laboratory (PML) could be the only clinical laboratory ever to pursue three quality improvement initiatives simultaneously. Even as it was in the early stages of implementing both Lean and Six Sigma methods, PML also decided to seek ISO 15189:2007 accreditati…

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Quest, LabCorp Slug It Out In Battle for Market Share

CEO SUMMARY: In reporting second quarter earnings, both Laboratory Corporation of America and Quest Diagnostics Incorporated discussed market developments. There were no surprises in the comments made by executives of both companies. Quest Diagnostics emphasized that it is hanging on to a…

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