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medical lab testing

Test price data shows major difference between Medicare lab fee schedule and private payers

This is an excerpt from a 1,500-word article in the November 7 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: THE DA…

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XIFIN Analysis of Its Real Price Data Shows Hospital Lab Price Effect

CEO SUMMARY: In a new analysis of data its lab clients will use to report market prices to CMS, XIFIN Inc., reports private payers paid independent labs a weighted average price that was 19.6% less than what Medicare pays for 20 of its highest-volume tests. By contrast, private payers pa…

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Medi-Cal to Cut Lab Pay on July 1 by 25% to 30%

CEO SUMMARY: Since 2011, state officials in California have aggressively cut laboratory testing fees for Medi-Cal, the state’s Medicaid program. Now state officials say they will implement a new methodology next month for determining lab testing fees. The new methodology is based…

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Could Health Insurers Be at War with Clinical Labs?

CEO SUMMARY: It may sound ridiculous to assert that the nation’s largest health insurers are now “waging war” against clinical labs. However, some very smart people in the profession of laboratory medicine are expressing this opinion. To support such a conclusion, they point to paye…

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Walgreens To Go National with Lab Tests in Stores

CEO SUMMARY: A disruptive innovation is one that shakes up an entire market or industry. By adding clinical lab testing to its health services offerings in more than 8,100 stores nationwide, Walgreens could disrupt the status quo in the clinical lab industry. Walgreens says its lab partne…

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Theranos Won’t Discuss Disruptive Lab Technology

CEO SUMMARY: In a partnership with Walgreens pharmacies, Theranos Inc. announced that it will run clinical lab tests on “micro-samples” and collect these blood samples without venipuncture. Even as Theranos touts the patient-friendly benefits of its proprietary diagnostic technology, …

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Predicting the End of Fee-for-Service Medicine

HOW DISRUPTIVE WILL THE END OF FEE-FOR-SERVICE MEDICINE be to the lab testing industry? I ask this question because we are about to leave the era of fee-for-service (FFS) medicine and move into the era of value-based and bundled reimbursement. Since World War II, FFS has been the overwhelmingly domi…

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Anatomic Path Insourcing Expected to Be Ongoing

CEO SUMMARY: Insourcing of anatomic pathology services by office-based physicians has been especially prevalent and is increasing among three specialties (gastroenterology, urology, and dermatology), according to a survey conducted last month. Survey respondents also indicated that the tr…

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