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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McKinsey Study Confirms Trend Toward Narrow Healthcare Networks on Health Insurance Exchanges; Smaller Clinical Laboratories and Pathology Groups Often Excluded

Ongoing shift to narrow provider networks excludes many medical laboratories, thus causing them to lose access to patients served by these networks

If there is any single trend that has worked against the clinical and financial interests of community clinical laboratories and hospital/health system lab outreach programs, it is the trend of narrow networks. When medical laboratories and other providers find themselves excluded from a payer’s provider network, they lose access to the patients served by that network.

Thus, it won’t be good news that a major consulting company has confirmed that the trend of narrow payer networks is intensifying. The study was conducted by healthcare consulting firm McKinsey and Company.

McKinsey concluded that insurers participating in the government’s Healthcare Exchanges continue to move toward narrow networks of healthcare providers. This trend often leaves smaller clinical laboratories, hospital lab outreach programs, and anatomic pathology groups on the sidelines as insurers attempt to reduce costs. (more…)

As Health Insurers Narrow Their Networks, Some Hospitals and Physicians Find Themselves Excluded, as Happened to Many Clinical Pathology Laboratories

Health insurers may be poised to leave hospitals and physicians out of their networks, thus potentially cutting out pathologists and clinical laboratories

Clinical laboratory companies that find themselves excluded from health insurers’ provider networks do not need to feel like they were singled out. That’s because health insurers are narrowing their networks by also excluding hospitals and physicians.

Years ago, the “narrow network” strategy was used by HMOs and health insurers to extract rock bottom prices from hospitals, physicians, and medical laboratories. Now this strategy is returning as health insurers develop what they call narrow networks. (more…)

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