TAG:
private payer
Florida Medicaid Contract Is On-Again, Off-Again
CEO SUMMARY: Start with a flawed idea: Medicaid lab testing costs in Florida can be cut by awarding an exclusive statewide contract to one laboratory company. Compound that bad idea by designing a contract awards process that guarantees the state will pay twice for a number of tests while…
Physician Group Path Ventures To Undergo OIG Review in 2005
IN ITS FISCAL YEAR 2005 WORK PLAN, the Department of Health and Human Services (DHHS) Office of Inspector General (OIG) will “identify and review relationships between physicians who furnish pathology services in their offices and outside pathology companies.” I…
Hospital Labs Produce Moderate Cost Increases
ALL PATHOLOGISTS AND HOSPITAL LAB ADMINISTRATORS who feel beat up about endless budget cuts should take heart. During the period 2000-2002, the cost of laboratory services in hospitals increased by 18%. That is something to brag about—and here’s why! The lab services cost increase was less than …
Peeking Into Finances Of Pathology Lab Condos
CEO SUMMARY: In the possession of THE DARK REPORT is a copy of revenue and expense projections shown by a pathology condo laboratory complex promoter to prospective urology groups. They project that even smaller urology groups can realize worthwhile income if they invest in a pathology co…
AP Test Over-Utilization Will Be One Achilles’ Heel
CEO SUMMARY: Over-utilization is likely to be a prime concern when federal healthcare enforcers eventually investigate in-house anatomic pathology laboratories owned by specialist physicians. Some in-house pathology lab condo promoters are basing financial performance on 100% utilization …
Lawyer Argues: UroCor Charges Are a Concern
CEO SUMMARY: Criminal charges in the case against three ex-UroCor executives will likely alter existing compliance practices that affect how a lab offers price discounts to physicians and the way a lab uses “waiver of charges” in situations where it is an out-of-network provider. Atto…
Urology & GI Physicians Bring Pathology In-House
CEO SUMMARY: Increasing numbers of urology and gastroenterology specialist groups are deciding to bring anatomic pathology services in-house. This phenomenon has gathered speed during the past year and is becoming a threat to the long-term financial and clinical stability of the anatomic …
In-House Versus Off-Site: Different Concerns
CEO SUMMARY: Three methods are available to specialist physician groups to capture anatomic pathology revenues generated by their patient population. Two methods have been around a long time. The pathology condo lab method is a new ploy. Of the three, one is generally accepted and more ea…
Changing Economics Motivate Urologists & GIs
CEO SUMMARY: Over the past 18 months, more specialist groups have created their own anatomic pathology laboratories than were created in the past five years. It’s a gold rush to tap and capture profits generated by the anatomic pathology services provided to their patient populations. T…
Molecular Diagnostics’ “Gap in Expectations”
CEO SUMMARY: This year’s Executive War College provided strong evidence that the twin trends of molecular diagnostics and Lean management methods are taking root within the laboratory industry. Each is a trend in its infancy. Molecular diagnostics will require considerable time before i…
CURRENT ISSUE
Volume XXXII, No. 14 – October 6, 2025
The Dark Report examines increasing healthcare costs for employers and how clinical labs can help those employers. Also, an in-depth case study shows how one hospital system regained its outreach program after originally ceding it to a national lab company, adding millions to the system’s bottom line.
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