CEO SUMMARY: Consultants who work with anatomic pathologists have several theories about why Anthem is enacting deep cuts of 50% to 70% for the professional component of many anatomic pathology services. While they have different ideas about what motivates the nation’s second largest health insurer, they agree that such reductions in payments will have a
Tag: pathology consultants
IT MAY NOT BE A COINCIDENCE THAT MANY RECENT NEWS CYCLES have more negative pathology news than positive pathology news. After all, laboratory medicine is at the core of most clinical care delivered to patients, so it’s no coincidence that pathology—both clinical and anatomic—is a prime target for government and private payers, along with federal investigators.
CEO SUMMARY: For medical directors and pathologists interested in improving their labs’ compliance with CLIA regulations, a report from federal and state inspectors of an inspection of the pathology lab at the Wake Forest Baptist Medical Center offers insights into what issues caught the inspectors’ attention. During their visit in February, the government lab inspectors
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 administrative burden on referring physicians, takes away a physicians’ right to choose a
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 Executive War College on Lab and Pathology Management, expert speakers will address how
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 of pathologists who regularly overutilize special stains,
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 paying for pathology services. Another factor is the
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 million available to fund these acquisitions. Brian Carr, RDX’s CEO, predicts that
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 News published an analysis of UnitedHealth’s strategy involving
CEO SUMMARY: Armed with $70 million, American Esoteric Laboratories (AEL) wants to build a national laboratory that offers a full menu of esoteric tests. It is building a primary laboratory in Dallas, which has one of the nation’s best air transport hubs. ThromboCare Laboratories and Viral Diagnostics, both based in the Dallas area, are just