Aetna CEO Declares Affordable Care Act in ‘Death Spiral’ in a Speech of Interest to Pathologists and Medical Laboratory Professionals

Apr 10, 2017 | Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Pathology, Laboratory Testing, Managed Care Contracts & Payer Reimbursement, Management & Operations

Aetna’s CEO Mark Bertolini highlights how the current system increases costs for both insurers and consumers At the moment, probably no issue is more politicized than that of the Affordable Care Act (ACA), often called Obamacare. Because it controls the design of health insurance coverage, it also influences the way health plans pay hospitals, physicians, clinical laboratories, and anatomic pathology groups. However, understanding the truth about what is working and what is not with the...

California Regulators Find Many Problems with the Provider Directories That Health Insurers Make Available to Consumers

Mar 20, 2015 | Coding, Billing, and Collections, Compliance, Legal, and Malpractice, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations

In California, a survey found significant inaccuracies in provider directories posted online—may trigger action by regulators to have insurers address this problem Transparency in healthcare is an important trend. In recent years, much attention has been given to increasing the transparency of the prices charged to patients by hospitals, physicians, and medical laboratories. But now the transparency trend is about to drive change in the provider directories that health insurance plans make...

Health Insurers Spending Big Dollars to Be Players in ‘Big Data’; Trend has Implications for Clinical Pathology Laboratories

May 8, 2013 | Laboratory Instruments & Laboratory Equipment, Laboratory Management and Operations, Laboratory News, Laboratory Pathology, Management & Operations

With healthcare reform likely to limit their growth, health insurers are expanding into data management to create new revenue streams Faced with swift changes in healthcare, many of which are not favorable to the traditional business model of private health insurers, the nation’s largest payers are positioning themselves to be major players in the management of “big data.” That may have interesting implications for clinical laboratories and anatomic pathology groups, which typically generate...
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