Tag: ncqa

Pre-authorization Coming For Pricey Molecular Tests

CEO SUMMARY: In response to the steep ramp-up in the utilization of genetic and molecular testing, the nation’s largest health insurers are preparing to institute new guidelines for coverage and reimbursement. These will include pre-authorization by physicians, a more effective genetic test coding arrangement for claims submission by laboratories, and implementation of evidence-based medicine (EBM)

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Key Trends Drive Change for Clinical Laboratories

CEO SUMMARY: Technology plays an ever-growing role in reshaping the organization and operation of clinical laboratories. New technologies figure prominently in THE DARK REPORT’S 2007 list of key trends in the clinical laboratory industry. Technological advances in instrument systems, informatics, and molecular diagnostics are giving laboratories new tools to improve clinical services and streamline lab

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Sonic Healthcare & CPL Make First Acquisition

CEO SUMMARY: Expanding from its base in Texas, Clinical Pathology Laboratories, Inc. (CPL) has acquired Cognoscenti Health Institute, LLC of Orlando, Florida. The deal was done discreetly and gives Sonic Healthcare, Ltd., parent of CPL, a solid foothold in Florida. Cognoscenti has also made impressive progress on building an evidence-based medicine service menu, something that

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Doctor “Pay to Perform” Launched by Medicare

CEO SUMMARY: Medicare’s just-announced physician “pay-for-performance” program will be a positive development for laboratories and pathologists. One consequence is that physicians will be measured on how effectively they use recommended lab tests in certain areas of care. This will give physicians a motive to work with laboratories which offer added-value lab testing services.

HEALTHCARE’S 800-POUND GORILLA

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“October 11, 2004 Intelligence: Late Breaking Lab News”

One reason why certain health plans are posting better numbers in several key clinical quality measures are “Pay for Performance” plans that reward providers with better outcomes, according to a just-released report by the National Committee for Quality Assurance (NCQA), based in Washington, DC. For example, NCQA data indicates that, among health plans which publicize

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Provider Performance Ranking Now Hitting Healthcare System

CEO SUMMARY: When 96 big corporations, employing 28 million people and spending $52 billion on healthcare, begin publishing hospital performance measurements so their employees can make informed choices, that’s big news! THE DARK REPORT predicts this is a major step toward detailed measurement of the quality and cost performance of providers, including pathology groups and

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LabCorp and CIGNA Ink New Provider Agreement

CEO SUMMARY: After four years of working with SmithKline Beecham Clinical Labs as its sole designated laboratory provider, Cigna Healthcare recently opened the door to Laboratory Corporation of America. THE DARK REPORT believes this development is first evidence that the nation’s largest managed care companies are finding sole source lab contracts may be overly restrictive

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