By Joseph Burns, from the Volume XXVI No. 9 – July 1, 2019 issue
CEO SUMMARY: Reviewing an AP practice’s expenses is vitally important today when payers are cutting reimbursement. In the past, government and private payers paid more for the technical and professional components of anatomic pathology work, but those rates have eroded. While conversations about revenue tend to obscure the need to talk about expenses, effective financial
By Joseph Burns, from the Volume XXVI No. 9 – July 1, 2019 issue
CEO SUMMARY: Following news last month about the biggest breach of personal health information in the clinical lab industry, lawyers representing some of the affected patients filed at least 12 class action lawsuits. Federal officials and attorneys general in multiple states also launched investigations. The breach occurred when hackers gained access to the data systems
By Joseph Burns, from the Volume XXVI No. 9 – July 1, 2019 issue
CEO SUMMARY: Organizations developing blockchain technology say it is a tamper-proof method of sharing data across networks and among providers, health insurers, and health systems. The Synaptic Health Alliance includes four of the largest health insurers, a health network, and Quest Diagnostics. Its first project, now in its second year, will use blockchain to create
By Joseph Burns, from the Volume XXVI No. 9 – July 1, 2019 issue
CEO SUMMARY: As of Aug. 1, Aetna will stop paying out-of-network pathologists for the professional component review of certain clinical pathology tests. Until now, the health insurer has paid for the professional component when out-of-network labs billed for clinical lab tests using the modifier 26. In a notice to labs, Aetna said it will pay
By Joseph Burns, from the Volume XXVI No. 9 – July 1, 2019 issue
CEO SUMMARY: Anthem is making big changes to its relationships with anatomic pathology groups. Getting most of the attention at the moment are the insurer’s letters announcing price cuts for anatomic pathology services of 50% to 70% of Medicare fees. But another major change may also trigger negative consequences for pathologists. Anthem is moving pathology
By Mary Van Doren, from the Volume XXVI No. 9 – July 1, 2019 issue
This is a synopsis of a 2,120-word article in the July 1, 2019 issue of THE DARK REPORT (TDR). The full articles are available to members of The Dark Intelligence Group.
CEO SUMMARY: Anthem is making big changes to its relationships with anatomic pathology (AP) groups. Getting most of the attention at the moment are the
By Mary Van Doren, from the Volume XXVI No. 8 – June 10, 2019 issue
This is a synopsis of two articles in the June 10, 2019 issue of THE DARK REPORT (TDR). The full articles are available to members of The Dark Intelligence Group.
CEO SUMMARY: The number of professionals working in the pathology field in the United States declined by 17.53% from 2007 to 2017 – leaving the U.S.
By Joseph Burns, from the Volume XXVI No. 8 – June 10, 2019 issue
CEO SUMMARY: Today, insurers get risk-adjusted payments for treating patients who have high-cost health conditions and they make risk-adjusted payments to physicians, hospitals, and other providers. At Northwell Health, the clinical lab saw the opportunity to leverage lab test data with other clinical and demographic data to identify patients who were undiagnosed or whose conditions were
By Joseph Burns, from the Volume XXVI No. 8 – June 10, 2019 issue
CEO SUMMARY: Pathologists seeking jobs will find that a more competitive job market is pushing salaries up over $300,000 per year on average. In addition, most new jobs come with a hiring bonus and funds for relocation of as much as $12,000 and for continuing medical education of $3,500. But these higher salaries also come
By Joseph Burns, from the Volume XXVI No. 8 – June 10, 2019 issue
CEO SUMMARY: The number of pathologists working in the United States declined by 17.53% from 2007 to 2017, according to recent research published in the Journal of the American Medical Association. When adjusted for the U.S. population, the researchers said the workforce of pathologists is smaller than that of other countries and those other countries
