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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Growing Wave of Hospital and Health System Mega-Mergers Means Changing Dynamics for Pathology and Clinical Laboratory Medicine

Accelerating pace of hospital consolidation brings new pressure to pathologists and clinical laboratory directors to maximize the value of pathology services

Large and financially-stable multi-hospital health systems are racing to form regional mega-systems. It’s a strategy to get ahead of the Affordable Care Act’s (ACA) mandate to improve quality and increase efficiency through coordinated care across the entire care continuum.

This growing national trend means further consolidation of clinical laboratory testing services within the merging organizations. For pathology groups, the new super-systems may encourage the different pathology groups within the system to consolidate into a single practice entity. This would help improve how pathology services are more deeply integrated into the care continuum. It would also facilitate contract negotiations between the pathologists and the parent health system. (more…)

Aetna, Humana, Kaiser, UnitedHealth Put Five Billion Medical Claims into Database for Healthcare Cost, Utilization Research

Data represents $1 trillion in spending since 2000 and contains clinical laboratory and pathology data

In what may turn out to be a positive development for clinical laboratories and pathology group practices, four of the nation’s five biggest health insurance companies will collaborate and put their medical claims data for billions of transactions into a single data base. Researchers say this database will give them an unprecedented ability to assess utilization trends and the clinical care delivered to patients covered by private health insurance.

The four health insurance companies that will provide data are:

The data provided by each of these health insurers will be submitted to the newly-created Health Care Cost Institute (HCCI). This data will consist of more than five billion medical claims dating back to 2000. These claims represent more than $1 trillion in spending. The health insurers are also providing the financing required to launch HCCI. (more…)

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