Jun 2, 2017 | Coding, Billing, and Collections, Laboratory Operations, Laboratory Pathology, Laboratory Testing, Management & Operations
Aetna expects 75% to 80% of its medical spending will be value-based by 2020 Many pathologists and medical laboratory executives may be surprised to learn how quickly private health insurers are moving away from fee-for-service payment arrangements. According to Forbes, the nation’s largest health insurance companies now associate nearly 50% of reimbursements they make to value-based insurance initiatives. This is a sign that value-based managed care contracting continues to gain momentum. And...
May 8, 2017 | Compliance, Legal, and Malpractice, Laboratory News, Laboratory Operations, Laboratory Pathology
Mergers that would have reshaped the nation’s largest insurance companies would directly affect the provider networks independent medical laboratories rely on For pathology groups and medical laboratories, the news about two thwarted deals involving mega insurance companies might be seen as a positive development. The proposed deals—Anthem’s $48-billion bid to buy Cigna, and a proposed $37-billion Aetna-Humana merger—would have reshaped the US health insurance industry had they not been...
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...
Oct 29, 2014 | Compliance, Legal, and Malpractice, Laboratory Instruments & Laboratory Equipment, Laboratory Management and Operations, Laboratory News
Pathology groups and medical laboratories may benefit if federal and state legislators legislate broadening of provider networks Insurers are increasingly using narrow networks as a business strategy to control costs. As a consequence, more consumers are complaining even as some excluded providers are suing health insurers. For pathologists and clinical laboratory managers, this accelerating trend of excluding providers means increasingly restricted access to patients. Health Insurers Walk a...
Mar 4, 2013 | Compliance, Legal, and Malpractice, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
Steep increases in insurance costs may leave patients with less money to cover deductibles and copayments for clinical laboratory tests Next year, consumers and small businesses can expect what one health insurance CEO says will be, “Premium rate shock for 2014.” As this happens, clinical laboratories and pathology groups are likely to find it even more difficult to collect co-pays, deductibles, and out-of-pocket fees from patients who had medical laboratory tests performed. The premium rate...
