CEO SUMMARY: Pathologists looking for a viable future in a healthcare system marked by integration of clinical care and value-based reimbursement will be interested to learn about Spectrum Medical Group based in Portland, Maine. This 180-member multispecialist group includes 22 pathologists (but no primary care physicians). It has found a way to serve ACOs, health
Tag: managed healthcare
MEDICAID PROGRAMS IN TWO STATES ARE CURRENTLY TARGETING laboratory testing services as a source of cost savings. It’s not coincidental that the states involved are Florida and California. During the past 15 years, both states have stayed at the cutting edge of managed healthcare. Many “innovations” (read: a way to pay providers less for the
CEO SUMMARY: California is a bellwether state for healthcare innovations. Six of its largest payers are collaborating on “Pay For Performance,” a program which pays financial incentives to physician group practices which achieve measurable outcomes in clinical care, patient satisfaction, and implementation of information technology. It’s expected to be a model for similar initiatives in
Without much fanfare or notice, Liposcience Inc. of Raleigh, North Carolina tested the waters for an initial public offering (IPO) last month. It found market conditions unfavorable for its proposed offering of $92 million and deferred its IPO. Liposcience, with annual revenues of $18.5 million, markets a cardiovascular test built upon nuclear magnetic resonance (NMR)
PACIFICARE BEGINS SERIOUS RESTRUCTURING TO SHIFT EMPHASIS
NOT SO MANY YEARS AGO, PacifiCare Health Systems Inc. was considered the quintessential embodiment of all that was expected to be good with managed healthcare.
The company’s business model was studied and copied in cities throughout the country. It shifted 100% of the risk on providers, used capitation almost exclusively,
It’s a sign of the times for managed healthcare. Pacificare Health System, Inc. will offer its first preferred provider organization (PPO) health plan. the PPO is being marketed in California, Oklahoma, and Texas. Enrollment starts this month. Until now Pacificare’s business model was solely built around a fully-capitated, provider-assumes-all-risk arrangement. But during the past 24
MANAGED CARE IS IN THE MIDST OF SHIFTING from a volume-buying discount club to a value-added partner in healthcare. During the past two years, THE DARK REPORT has identified developments in the marketplace supporting this trend and provided these insights to our clients and regular readers.
Further proof of this shift in the business model of
CEO SUMMARY: Technology to enhance and improve conventional Pap smear screening was introduced into the clinical marketplace almost five years ago. But the clinical laboratory industry has yet to embrace these various technologies in any meaningful way. Like the introduction of liquid preparation methods for Pap smear testing, these various technologies to enhance and automate
CEO SUMMARY: Managed care analyst Michael Casey believes HMO enrollment will peak, possibly in 2000. PPOs (preferred provider organizations) are gaining members at an increasing rate. Within California, the provider revolt over deficient reimbursement levels is escalating. Orange County’s largest medical group, with 500 doctors, announced it would not accept new HMO contracts and might
CEO SUMMARY: Pathology business consolidation and regionalization continues. Pathology Consultants of America, Inc. (PCA) and PathSOURCE, Inc. announced their intention to merge last month. The combined company will be called Inform DX, Inc. and will compete nationally for anatomic pathology business. Inform DX represents a new business model for the anatomic pathology profession.
TWO WELL-FINANCED anatomic