News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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American Medical Association’s Study of Nation’s 25 Largest Health Insurers Indicates that Biggest Companies Hold Dominant Market Share in Most Regional Markets

Survey results show pathologists and clinical lab managers why largest health insurers have market clout and can exclude local labs from their provider networks

Over the past two decades, ongoing mergers and acquisitions of health insurance organizations have led to ever-greater concentration of market share, even as the number of large health insurance companies has shrunk. One consequence of this trend is that many clinical laboratories and anatomic pathology groups have lost access to managed care patients.

The degree of market concentration will surprise most pathologists and medical laboratory professionals. The concentration of market ownership is clearly demonstrated by the fact that the 25 largest health insurers in the United States now control two-thirds of this $744-billion market. But the largest plans are not necessarily the best, according to 2013 consumer satisfaction surveys conducted by J.D. Power & Associates. (more…)

’Hospital Wars’ in Boise Reflect National Trend toward Consolidation of Independent Physician Practices in Ways that Alter the Clinical Lab Testing Market

State and federal investigations into possible antitrust violations arising from provider consolidation could have implications for the nation’s independent medical laboratories

Physician-practice acquisition deals are drawing increased scrutiny from federal and state investigators concerned about possible antitrust violations. Because ownership of medical groups can play a role in how the owners decide on a medical laboratory testing provider, these anti-trust reviews could inhibit concentration of ownership by large hospitals or health systems.

Hospitals, private equity firms, and even health insurers are racing to buy up independent physician practices. At the same time, physicians are open to selling their medical practice and working as employees after the sale is completed. (more…)

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