CEO SUMMARY: In a letter to the National Correct Coding Initiative, the American Clinical Laboratory Association (ACLA) raised significant concerns about new language in the policy manuals for Medicare and Medicaid. ACLA said the new NCCI guidelines for molecular and other tests requiring multiple steps for one specimen reduce transparency, increase the administrative burden on
Tag: pathology testing
CEO SUMMARY: Since 2011, the University of Florida Health System has used pharmacogenetic test (PGx) results to guide physicians when they prescribe certain drugs. This initiative has improved patient outcomes, reduced the overall cost per episode of care, and gained partial reimbursement from health insurers for PGx test claims. As this testing becomes more widespread, clinical
This is an excerpt from a 2,400-word article in the Nov. 20, 2017 issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group.
CEO SUMMARY: Here at the dawn of the new era of value-based
EVEN INTO THE MID 1980s, coal miners used canaries as an early-detection system for the presence of carbon monoxide and other toxic gases. In this way, canaries served as a sentinel species to save miners’ lives.
Clinical laboratories and pathology groups don’t have a sentinel species to warn them about trouble ahead, but they do have
CEO SUMMARY: With each passing year, the primary role of hospital and health system labs evolves in a different direction than that of independent lab companies. This trend is a response to the creation of integrated delivery networks paid on value and how they are scored on their ability to keep patients out of hospitals
CEO SUMMARY: With programs now at the nation’s two largest insurers, is it possible to argue that prior-authorization is going mainstream? Some observers say, yes, as THE DARK REPORT predicted. What is certain is that starting Nov. 1, UnitedHealthcare is requiring prior authorization for genetic and molecular tests for its fully-insured commercial members nationwide. That
CEO SUMMARY: Announced last month, the new laboratory joint-venture partnership with Sonic Healthcare’s Sunrise Clinical Laboratories will allow WCHN to compete with other health systems and prepare to respond to health insurers’ requests that hospital systems offer lower rates in value-based payment models. WCHN has already seen payers shift to low-cost providers. For this reason,
CEO SUMMARY: Is the New Year’s spate of deals involving the sales of hospital lab outreach programs and a new joint venture the first tremors of an impending earthquake of similar transactions? In the first 10 weeks of 2017, Laboratory Corporation of America, Quest Diagnostics, and Sonic Healthcare announced significant agreements to purchase sizeable hospital
ANOTHER ACADEMIC MEDICAL CENTER decided to cash in on the value of its outreach lab. On Jan. 10, Laboratory Corporation of America announced it would acquire the lab outreach business of Mount Sinai Health System of New York City.
Terms of the transaction and purchase price were not disclosed. The deal is expected to close by
CEO SUMMARY: It is one of those clinical laboratory deals that was announced before the end of 2015. Laboratory Corporation of America said it will acquire most of the operating assets of Pathology Inc., of Torrance, California, and that the acquired lab “will cease operations” upon the closing of the transaction. It has been six