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utilization management

How Northwell’s Lab Team Demonstrated Value Over 10 Years

CEO SUMMARY: Among hospital administrators, the popular wisdom is that their clinical lab is a cost center. This thinking leads them to consider drastic cost-management strategies that include partnering with commercial labs to manage in-hospital lab testing and the outright sale of lab o…

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Reacting to PAMA Cuts, Lab Works with Payers

CEO SUMMARY: Before Medicare’s lab test price cuts went into effect last year, Health Network Laboratories began discussions with private health insurers and nursing home clients about the possibility of renegotiating their contracts. In these discussions, HNL promoted the value it deli…

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Cleveland Clinic Lab dramatically reduces doctors ordering unnecessary tests

This is an excerpt from a 2,920-word article in the May 7, 2018 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.  …

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Cleveland Clinic Lab Has Multi-year Test Utilization Success

CEO SUMMARY: Over the 24 months of a first-generation round of laboratory test utilization management projects, the Cleveland Clinic laboratories prevented more than 30,000 duplicate or inappropriate test orders, saving almost $2.7 million. Now implementing a second-generation of labtest …

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Labs Begin Applying Lean to Cut Costs, Add Value

CEO SUMMARY: In more than 40 presentations by 55 speakers, two big themes dominated the 11th annual Lab Quality Confab in New Orleans last week. One theme is the urgent need to cut clinical laboratory costs. The second theme is the need for both clinical labs and anatomic pathology groups…

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Anthem Launches Program to Manage Genetic Tests

CEO SUMMARY: Pre-authorization of genetic tests is coming to physicians serving patients insured by Anthem, Inc. Its specialty benefits management company, AIM Specialty Health, will manage the program. AIM will work with InformedDNA, a company that specializes in genetic testing clinical…

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Cigna Expands Program For Genetic Counseling When Genetic Tests Are Needed

CEO SUMMARY: For three years, Cigna has required genetic counseling for members seeking genetic testing for hereditary breast, ovarian, and colorectal cancer, and for a particular heart condition. Such counseling increased member satisfaction, causing Cigna to expand the program. It now r…

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New Company Tracks Details and Prices For 60,000 Molecular and Genetic Tests

CEO SUMMARY: Advances in the speed, accuracy, and cost of next-generation gene sequencing making it possible for clinical labs to create thousands of new tests. How many new tests? NextGxDx, an information technology company, says the nation’s clinical laboratories are introducing new m…

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Opportunities Ahead for Labs That Prepare

AT THE END OF EVERY YEAR, IT’S ALWAYS SMART BUSINESS FOR EVERY LAB to peer into the future specifically to identify the best clinical and financial opportunities. With the New Year just a few week…

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Hospital Lab Shares Ten Ways to Create Value with Lab Tests

CEO SUMMARY: Across the nation, labs in hospitals and health systems are feeling pressure from shrinking lab budgets and the need to be a contributor to the integration of clinical care. At Henry Ford Health System in Detroit, the clinical laboratory and department of pathology have respo…

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