Few Options for Pathology Groups Facing Anthem’s Payment Cuts

By Joseph Burns | From the Volume XXVI No. 12 – September 3, 2019 Issue

FACED WITH DEEP CUTS in payment for anatomic pathology professional component services from Anthem Inc., pathologist have only a few options in how they can respond, according to consultants who work with AP groups. “These are dire cuts to anatomic pathology reimbursement,” said…

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Medicare Data Makes Pathology Prices Public

By Joseph Burns | From the Volume XXV No. 15 – October 22, 2018 Issue

CEO SUMMARY: Each year since 2015, Medicare officials have posted the prices charged by every physician. That now makes it possible for pathology group practices to conduct a price study of their region and state to learn how their group’s prices compare with other pathology providers. …

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Texas Lawmakers Asked to Stop UHC and BeaconLBS

By Robert Michel | From the Volume XXIV No. 5 – April 3, 2017 Issue

CEO SUMMARY: In a letter to the Texas Legislature, 20 Texas medical societies say UnitedHealthcare’s BeaconLBS program would be detrimental to patient care. The Texas Medical Association and the Texas Society of Pathologists said they were concerned that the program increases the admini…

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Understanding the Future Of Laboratory Medicine

By Robert Michel | From the Volume XXIII No. 4 – March 21, 2016 Issue

CEO SUMMARY: Healthcare’s transformation is now far enough along that most clinical labs and pathology groups are either feeling the financial pain or are excitedly developing ways to deliver more value from lab testing services. On April 26-27, at the 21st annual …

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Medicare Special Stain LCD May Hinder Pathology Workflow

By Joseph Burns | From the Volume XXI No.16 – November 24, 2014 Issue

CEO SUMMARY: Under a proposed rule for Medicare region J-11, a pathologist will no longer be able to use “reflex templates or pre-orders for special stains and/or IHC stains prior to review of the routine H&E.” While the proposed LCD is designed to target a relatively small number…

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Anatomic Pathology Business Faces Uncertain Future

By Robert Michel | From the Volume XXI No. 4 – March 17, 2014 Issue

CEO SUMMARY: There’s a day of reckoning on the way for the traditional business model of the private pathology group practice. At most risk are smaller pathology groups that typically have five or fewer pathologists. Blame it on the reduced prices that Medicare and private insurers are …

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New Lab Company Intends to Buy Outreach Labs

By Joseph Burns | From the Volume XIX No. 9 – June 25, 2012 Issue

CEO SUMMARY: Based in Brentwood, Tennessee, Regional Diagnostic Laboratories (RDX) says it wants to purchase the laboratory outreach programs of nonprofit community hospitals. RDX is a partnership with Warburg Pincus, a New York investment company. It is a credible buyer and has $250 mill…

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Why Insurers Are Buying Office-Based Physicians

By Robert Michel | From the Volume XVIII No. 10 – July 25, 2011 Issue

WHEN THE NEWS BECAME PUBLIC earlier this month that UnitedHealth Group was quietly purchasing physician groups in selected areas of the country, there was a flurry of news articles recognizing this as a new trend. These news stories came after July 1. That’s the date when Kaiser Health N…

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Mobile Pathology Service Fuels Increased Revenue

By Robert Michel | From the Volume XIV No. 4 – March 12, 2007 Issue

CEO SUMMARY: When pathologist Raman Sukumar, M.D. founded a generalist pathology practice in 2003, he was convinced that local doctors would support his vision of pathology at the point of care. That vision was validated by rapid acceptance of his mobile pathology laboratory and a steady …

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How Local Path Groups Can Keep Patient Access

By Robert Michel | From the Volume XI No.13 – September 20, 2004 Issue

CEO SUMMARY: For pathology groups operating their own histology and cytology labs, a growing problem is access to patients covered by exclusive managed care contracts. In the Northeast, several persistent pathology group practices are using some effective business strategies to fight this…

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