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

Feb 17, 2017 | Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations

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...

McKinsey Reports That Consumers Will Find Fewer Options under the ACA in 2017 while Fewer Health Plans Means Less Access for Clinical Laboratories

Dec 21, 2016 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Pathology

Local medical labs and pathology groups are often excluded from narrow networks. Thus, another round of “network provider reduction” is a serious issue Total enrollment in health insurance products may be increasing, but in its recently-issued study, McKinsey and Company determined that the Health Insurance Marketplace (Health Exchange) is shrinking even as the number of enrollees continues to rise. The development is unfavorable to the nation’s clinical laboratories and pathology groups...

Clinical Laboratories and Pathology Groups May See Fewer Fee-For-Service Payments as More Hospitals and Health Systems Become Self-Insured

Sep 28, 2015 | Coding, Billing, and Collections, Laboratory Instruments & Laboratory Equipment, Laboratory Management and Operations, Laboratory Pathology, Laboratory Testing

As national health insurers push more risk to hospital systems and medical groups, many hospital administrators become more interested in establishing their own health insurance companies New modes of provider reimbursement—such as bundled payments and budgeted payments—are motivating hospitals and health systems to reconsider their existing relationships with health insurers. Hospital administrators want to control the dollars they save by improving patient care, instead of allowing insurance...
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