CEO SUMMARY: Many anatomic pathology groups are watching their revenue decline and margins shrink on the same or greater case volume. These trends make it imperative to have a deeper understanding of the operational and financial variables that contribute to stability in the group’s finances and pathologist compensation. One expert on the financial complexity of anatomic
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A pathology group is an organization of clinical pathologists working on the diagnosis of disease based on laboratory analysis of bodily fluids such as blood and urine, as well as tissues, using the tools of chemistry, clinical microbiology, hematology and molecular pathology. Clinical pathologists work in close collaboration with medical technologists, hospital administrations, and referring physicians.
The business model of a pathology group has traditionally been as a private group practice, including solo practitioner, medical group partnership, professional corporation (PC), limited liability company (LLC), and similar professional business organizations. It is common for pathology groups to have contracts with one or more hospitals to provide anatomic pathology professional services and clinical pathology professional services.
Pathology itself is a significant component of the causal study of disease and a major field in modern medicine and diagnosis. The term pathology may be used broadly to refer to the study of disease in general, incorporating a wide range of bioscience research fields and medical practices, or more narrowly to describe work within the contemporary medical field of “general pathology,” which includes a number of distinct but inter-related medical specialties which diagnose disease mostly through the analysis of tissue, cell, and body fluid samples.
Pathologists in hospital labs and pathology groups practice as consultant physicians, developing and applying knowledge of tissue and laboratory analyses to assist in the diagnosis and treatment of individual patients. As scientists, they use the tools of laboratory science in clinical studies, disease models, and other experimental systems, to advance the understanding and treatment of disease.
Clinical pathologists in a pathology group administer a number of visual and microscopic tests and an especially large variety of tests of the biophysical properties of tissue samples involving automated analyzers and cultures. Sometimes the general term “laboratory medicine specialist” is used to refer to those working in clinical pathology, including medical doctors, PhDs and doctors of pharmacology.
Immunopathology, the study of an organism’s immune response to infection, is sometimes considered to fall within the domain of clinical pathology.
Becoming a pathologist entails one of the lengthiest education and training tracks of all physicians. Requirements include four years of undergraduate study, plus four years of medical school, plus a minimum of four to five years of post-graduate training in pathology residency.
CEO SUMMARY: When Ascension Wisconsin wanted one pathology group to serve its needs statewide, North Shore Pathologists responded to the request for proposal by focusing on how pathologists can improve patient care through a patient-centered model. Other pathology groups responded with proposals that emphasized the financial aspects of the relationship. Focusing on patient care won
CEO SUMMARY: Sonic Healthcare, Ltd., announced that it would pay $540 million—a multiple of 9.2 times EBITDA—to acquire Aurora Diagnostics, the anatomic pathology company based in Palm Beach Gardens, Fla. Sonic will gain 32 pathology practice sites and add 220 pathologists to its network of regional clinical and pathology laboratories. The transaction marks the end
CEO SUMMARY: With the year end approaching, lab buyers and sellers are working to finalize deals that may have been in discussion for months. The first big lab acquisition for this season came on Nov. 27, when Quest Diagnostics announced it was acquiring Boyce and Bynum Pathology Laboratories of Columbia, Mo. The pathologists will keep
CEO SUMMARY: This year’s list of the Top 10 Lab Industry Stories for 2018 is dominated by new directives from Medicare and private health insurers, as well as significant decisions by federal courts. Collectively, these developments create new compliance risks for all clinical laboratories and anatomic pathology groups. What is more notable about these top
CEO SUMMARY: At the last minute, Congress added all clinical laboratories to a far-reaching provision in the newly-enacted Support for Patients and Communities Act. Unlike the Anti-Kickback Statute, this provision applies to all payers, both government and private, and offers no safe harbors. Lab experts say this new law could turn relatively innocuous and heretofore
CEO SUMMARY: At the last minute, Congress added all clinical laboratories to a far-reaching anti-kickback provision in the newly-enacted Support for Patients and Communities Act. This provision applies to all payers, both government and private. Lab experts say this new law could have a negative effect on patient care because it could make relatively innocuous
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. A national pathology consultant points out that one way
CEO SUMMARY: Payers and health system administrators generally agree that healthcare is moving away from fee-for-service toward value-based payment. Because adoption of value-based contracts is slower for pathologists than for other providers, pathologists have the opportunity to define how provider systems can pay for value contributed by pathologists. However, to take advantage of this opportunity,
TWO MAJOR, DISRUPTIVE CHANGES lie ahead for both clinical laboratories and anatomic pathology group practices. Each disruptive factor has nothing to do with how payers select in-network labs or reimburse for lab testing services.
Rather, one of these two major changes involves fundamental advances in the diagnostic technologies used by labs to diagnose disease and guide