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managed care

Fla. Lab Sells to Labcorp, But Keeps Nursing Homes

CEO SUMMARY: Vista Clinical Diagnostics of Clermont, Fla., is betting big on the nursing home sector just when many labs serving nursing homes are worried about steep Medicare cuts coming Jan. 1. After selling its physician office referral testing, 35 patient service centers, and a mobile…

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Lab Scheme Recruits Hospitals To Bill as In-Network Providers

CEO SUMMARY: Management companies using a new generation of potentially fraudulent schemes are targeting hospitals and health systems for arrangements that use questionable means to increase lab test volume and revenue. The management companies often use the term “hospital outpatient de…

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New source of lab test abuse surfaces in the form of HOPDs and MSOs

This is an excerpt from a 2,350-word article in the Oct. 30, 2017 issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group. CEO SUMMARY: …

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LabCorp, Quest Open PSCs in Retail Stores

CEO SUMMARY: In the past year, both national laboratory companies have increased the number of patient service centers they operate in retail pharmacies and grocery stores. But these PSCs are not serving direct access testing (DAT) customers. Rather, early evidence indicates that patients…

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Two Largest Payers Start Lab Test Pre-Authorization

CEO SUMMARY: Once Anthem and UnitedHealthcare establish their respective genetic test prior-authorization programs, a new era for genetic testing will commence. The 80 million beneficiaries served by these two payers make up half of the individuals who have private health insurance. It is…

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Invitae Investing Heavily To Expand Market Share

CEO SUMMARY: In its first five years of offering clinical tests, Invitae has outspent revenue by $330.7 million. Yet its executives are confident that their company is on a path to becoming one of the dominant players in the genetic testing sector. This profile of Invitae will help pathol…

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Konica Minolta to Pay Up to $1 Billion for Ambry

CEO SUMMARY: It’s the second time in six years that a Japanese corporation paid a high price for a genetic testing company in the United States. Konica Minolta will purchase Ambry Genetics for $800 million at closing and $200 million upon hitting certain financial metrics. In 2011, Miraca H…

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Ambry Genetics $800M Sale to Konica Minolta Is a Big Deal for Lab Industry

This is an excerpt from a 2,026-word article in the July 17, 2017 issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group. …

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Why It Matters That Your Lab Has Low Test Prices

TODAY, THE LAB INDUSTRY FACES A CONTRADICTION when setting prices for individual lab tests. At one extreme, a certain sector of labs seeking to win exclusive managed care contracts sets high-volume routine test prices at or below the fully-loaded cost to perform those tests. At another extreme, labor…

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Lab’s Low Gene Test Price Gets Insurers’ Attention

CEO SUMMARY: At a time when most molecular and genetic testing companies are struggling to gain coverage for their tests, this Silicon Valley-based lab company has become an in-network lab provider for a number of health insurers—including three of the nation’s largest payers. It did …

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