TAG:
managed care
Philly Blue Cross Contract: LabCorp In; Quest Out
CEO SUMMARY: Independence Blue Cross in Philadelphia decided to select Laboratory Corporation of America for its new eight-year managed care contract that took effect on July 1. However, the real story is the aggressive bidding war between the two national labs. Sources say LabCorp bid an…
In this Philadelphia Story, LabCorp Uses 2007 Script
CEO SUMMARY: There’s a managed care contracting play-book that seems to be working better for Laboratory Corporation of America than it does for Quest Diagnostics Inc. On July 1, LabCorp became the exclusive national lab provider for Independence Blue Cross of Philadelphia. For the past…
NorDx CEO Shares Five Rules Critical to every Lab’s Success
CEO SUMMARY: To meet the financial challenges of healthcare today, clinical labs and pathology groups can follow the five classic lab rules of success. However, as noted by Stan Schofield, CEO of NorDx Laboratories in Scarborough, Maine, the “old school” methods need …
Test Utilization Targeted by UnitedHealth, LabCorp
CEO SUMMARY: Many independent laboratories serving patients in Florida are unhappy about the decision by UnitedHealth (UNH) to initiate a pilot program that calls for LabCorp’s BeaconLBS subsidiary to handle prior authorization for certain lab tests. UNH’s laboratory benefit managemen…
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…
Dealing with Realities of Changing Market
CEO SUMMARY: Swift transformation of the American healthcare system is causing financial challenges for those clinical labs and pathology groups that have been slow to react to these developments. At NorDx Laboratories in Scarborough, Maine, the team is following the classic five rules fo…
At Mid-Year, Labs Struggle to Get Paid for Many Tests
CEO SUMMARY: At a recent coding and billing conference, pathology and lab clients of one of the nation’s largest revenue management companies agreed that three trends have caused lower revenues since the start of 2014. One trend seen by labs involves higher deductibles and copayments fr…
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 …
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…
BRLI-Horizon BCBS Lawsuit Is Window to Payer Actions
CEO SUMMARY: Do “actions speak louder than words?” In New Jersey, one lab company sued a major health insurer for “breach of contract and fraud.” Court documents include claims describing how one health insurer became ever more sophisticated in how it played one public lab company…
CURRENT ISSUE
Volume XXXII, No. 6 – April 21, 2025
Now that a federal judge has vacated the FDA’s LDT rule, The Dark Report analyzes the judgement and notes the various steps the FDA could take in response. Also, lab testing at pharmacies is proving to be less successful than was once anticipated.
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