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...

Castlight Health Offers Employers a Cloud-based Price Transparency Tool to Help Employees Shop for Low-Cost, High Quality Health Services

Similar to Oscar Healthcare in New York, this California-based enterprise technology company offers services to make it easy for individuals to see providers’ prices, including medical laboratory test prices Another company has entered the marketplace with their unorthodox business model to support health insurance programs. One cornerstone feature is a tool that enables both employers and beneficiaries to see the prices of different providers. This young player in the health benefits...

Push by ACOs to Give Patients a Stake in Their Healthcare Provides Opportunities for Engagement by Clinical Laboratories and Pathologists

With payouts riding on patient outcomes and value, ACO providers will welcome innovative services that clinical labs and pathologist could provide that improve patient outcomes Both private health insurance companies and employers are betting on value-based insurance as the key to improving healthy behavior in patients. This will require more patient engagement in managing their chronic conditions. It will also include motivating patients to consider less expensive treatment options,...

Why Health Insurers Want to Pre-Authorize Genetic and Expensive Clinical Pathology Lab Tests

McKesson Corp. and MuirLab working to implement lab-friendly strategies to meet payer needs Unfolding events make it likely that genetic testing will become a good news/bad news story for local clinical laboratories and pathology groups. The good news is that genetic tests and molecular assays will bring more diagnostic precision to patients and their physicians—and that points to an auspicious future for pathology and laboratory medicine. The bad news is that payer requirements in the United...

New Managed Care Contract Opportunity for Clinical Labs and Pathology Groups

As health insurers build patient-friendly web sites, they now want all the lab test data For laboratories wanting to contract with managed care plans, it will soon be “all about the data.” In upcoming contract renewal talks, expect health insurers to have a keen interest in working specifically with those clinical laboratories and pathology groups which can interface and electronically provide lab test data. Dark Daily is first to identify this important development. It creates an opportunity...