Did National Labs Sign Value-based Payer Contracts?

Did National Labs Sign Value-based Payer Contracts?

IT IS AN IMPORTANT SIGN OF THE TIMES when press releases about the two new national lab services agreements that UnitedHealthcare just announced with Laboratory Corporation of America and Quest Diagnostics emphasize how value-based programs will be an important element in the health insurer’s relationships with the two national lab companies.

In fact, the joint announcements issued by UnitedHealthcare (UHC) and LabCorp, and UHC and Quest, contain one identical paragraph that emphasizes the role of value-based programs involving lab testing. UHC wrote:

As part of the expanding relationship, UnitedHealthcare and [insert LabCorp or Quest here] will collaborate on a variety of value-based programs, bringing the same aligned incentives and enhanced patient experience to lab services as exist today in accountable care arrangements between UnitedHealthcare and more than 1,100 hospitals and 110,000 physicians. Working together, UnitedHealthcare and [insert LabCorp or Quest here] will strategically change the way we are able to support consumers’ healthcare needs by using real-time data sharing to help better anticipate people’s care options—and reducing gaps in care—similar to the model UnitedHealthcare already uses to integrate medical and pharmacy data.

The decision to include the identical paragraph in both press releases demonstrates that UnitedHealthcare is actively seeking to leverage lab test data in ways that improve patient outcomes and contribute to a measurable reduction in the overall cost per healthcare encounter.

Stated differently, UnitedHealthcare is making a public statement that it intends to develop forms of remuneration that can replace the traditional fee-for-service reimbursement it has paid for clinical laboratory tests. All clinical laboratories and pathology groups should consider this an early warning to get their own houses in order and proactively develop clinical offerings that use lab tests to create more value for the physicians and patients they serve.

This goal is the target of the four health system labs involved in Project Santa Fe. They are working to demonstrate ways that the Clinical Lab 2.0 model can deliver value. At last month’s Executive War College, the Project Santa Fe labs presented case studies on their early successes at delivering more value with lab tests.

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