Role of Price Transparency During Path Contract Talks

By Robert Michel | From the Volume XXXII, No. 5 – March 31, 2025 Issue

CEO SUMMARY: Pathology groups have a much better opportunity to turn the tables on payers and other third parties during contract negotiations if they come armed with the data and other information recommended by two well-respected pathology experts…

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Some Health Plans Drop Deductibles as Response to New Consumerism

By Robert Michel | From the Volume XXXII, No. 4 – March 10, 2025 Issue

It may surprise many pathologists and clinical laboratory administrators to learn that one major health insurer’s best-selling plan has only copays and no deductible, no coinsurance, and no cost-shifting! That plan is Surest, a group plan offered by UnitedHealthcare in recent ye…

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Review of Genetic Testing Companies During 2024

By Robert Michel | From the Volume XXXII, No. 1 – January 6, 2025 Issue

CEO SUMMARY: Investors in genetic testing companies are taking it on the chin these days. During 2024, a number of the nation’s largest firms providing genetic test services reported significant losses. Other genetic testing companies are dealing with class action lawsuits claiming that…

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Gold Cards Offer Labs Limited Relief for Prior Auth Woes

By Virchow | From the Volume XXXI, No. 17 – December 16, 2024 Issue

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How Private Health Insurers May Respond to FDA LDT Regulation

By Virchow | From the Volume XXXI, No. 8 – June 10, 2024 Issue

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UnitedHealth Group Faces DOJ Antitrust Probe

By Robert Michel | From the Volume XXXI, No. 6 – April 29, 2024 Issue

CEO SUMMARY: Recent events have not been kind to UnitedHealth Group and its subsidiaries UnitedHealthcare and Optum. In February, just as UHG’s Change Healthcare division was hit with a major cyberattack that disrupted billions of dolla…

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Labs Should Prepare for Arrival of ‘Perfect Storm’

By Robert Michel | From the Volume XXXI, No. 3 – February 26, 2024 Issue

CEO SUMMARY: In the near future, clinical labs and pathology groups will need to address three major developments. One involves the FDA proposed LDT rule. A second is the adoption by payers of guidelines that require genetic test claims to have Z-Codes. The third centers around coming ref…

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Year’s Top 10 Lab Stories Contain Surprises & Twists

By Robert Michel | From the Volume XXX, Number 18 – December 26, 2023 Issue

CEO SUMMARY: With the SARS-CoV-2 pandemic now in the rearview mirror of the nation’s clinical labs and pathology groups, the important news stories of 2023 were mostly about developments where the consequences will influence laboratory operations in coming years. Artificial intelligence…

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Why Payers Bristle as Labs Submit Inpatient Fees for Outreach Tests

By Virchow | From the Volume XXX, Number 18 – December 26, 2023 Issue

        EDITOR’S NOTE: Our column, Virchow, is written…

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Payers Are Right to Be Wary of Claims for Some LDTs’ Value

By Virchow | From the Volume XXX, Number 17 – December 4, 2023 Issue

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