UHC Reportedly Cutting Ties with Regional Labs

By Joseph Burns | From the Volume XXV No. 18 – December 24, 2018 Issue

CEO SUMMARY: By cutting out smaller, regional labs, UnitedHealthcare appears to want to shift an unknown percentage of its lab test volume to Quest Diagnostics Inc., which it recently restored to its national provider network. Clinical lab directors should be concerned about this developm…

Read More

---

PAMA Economics Drives Merger Of Two Seattle-Area Pathology Groups

By Joseph Burns | From the Volume XXIV No. 1 – January 9, 2017 Issue

CEO SUMMARY: Among the three chief reasons for the merger of CellNetix and Puget Sound Institute of Pathology, the most compelling was the need to address the challenges in the current reimbursement environment and to prepare for reductions in payment to pathologists expected in the comin…

Read More

---

Quest to Manage Six Labs at HCA HealthONE Hospitals

By Joseph Burns | From the Volume XXIII No. 8 – June 13, 2016 Issue

CEO SUMMARY: For decades, hospitals were reluctant to allow any outside lab company to run their inpatient lab operations because they preferred to maintain control over quality results and turnaround times. That attitude may be changing as health systems face increasing margin compressio…

Read More

---

Just 66 of 742 Labs Submit Rate Data to California Department of Health Care Services

By Joseph Burns | From the Volume XXIII No. 5 – April 11, 2016 Issue

…

Read More

---

Protecting Access to Medicare Act of 2014: Will price reporting rule drive small labs out of business?

By Mary Van Doren | From the Volume XXII No. 14 – October 5, 2015 Issue

This first assessment of the PAMA (Protecting Access to Medicare Act of 2014) proposed rule on market reporting of lab prices gives pathologists and lab executives insights about the good, the bad, and the…

Read More

---

Labs Have Questions for CMS on Proposed Rule

By Joseph Burns | From the Volume XXII No. 14 – October 5, 2015 Issue

CEO SUMMARY: On September 25, CMS took a long overdue step to issue a proposed rule on how medical laboratories are to report private market prices for lab tests to the Medicare program during 2016. The proposed rule provides insights as to how CMS envisions pricing new tests and advanced…

Read More

---

CMS Releases Draft of PAMA Market Price Rule

By Joseph Burns | From the Volume XXII No. 14 – October 5, 2015 Issue

CEO SUMMARY: CMS’ proposed rule details how it will collect private market data, then use that data to establish prices for the Medicare Part B Clinical Laboratory Fee Schedule beginning in 2017. The proposed rule will limit data reporting to les…

Read More

---

Humana Reduces Number of Labs in its Networks

By Joseph Burns | From the Volume XXI No. 14 – October 13, 2014 Issue

CEO SUMMARY: In Ohio, a lab director said his lab was not informed directly about its exclusion from the Humana lab network. Lab officials got the word from their client physicians. In Texas, another lab director said Humana cut 35 lab contracts, reportedly because the insurer wanted to s…

Read More

---

Excluding Lab Competitors Helps Big Labs Grab Greater Market Share

By Joseph Burns | From the Volume XXI No. 9 – June 30, 2014 Issue

CEO SUMMARY: Changes in healthcare are motivating health insurers and the nation’s largest lab testing companies to enter into contracts in which the large lab company lowers its lab test prices to the payer in return for having the payer exclude that lab company’s toughest competitor…

Read More

---

Whole Genome Sequencing Is Poised for Clinical Use

By Robert Michel | From the Volume XXI No. 5 – April 7, 2014 Issue

CEO SUMMARY: Pathologists and clinical lab managers interested in following the advances in use of whole human genome sequencing for clinical purposes should follow the money. Within weeks of obtaining FDA clearance for its MiSeqDx system and reagents, Illumina had inked major agreements …

Read More

---