May 1, 2015 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory Pathology, Managed Care Contracts & Payer Reimbursement
If bundled payment becomes more common in treatment of cancer, then anatomic pathologists need a strategy to demonstrate their clinical value to physicians and payers
MD Anderson Cancer Center and UnitedHealthcare (NYSE: UNH) announced a bundled payment agreement for the treatment of certain types of cancer. This development has implications for anatomic pathologist who provide cancer testing services to hospitals throughout the United States.
The new three-year pilot at MD Anderson’s Head and Neck Center in Houston, Texas, is the first use of a bundled payment model in a large, comprehensive cancer center. Officials say it is expected to lower costs while improving the quality of patient care and outcomes. As many as 150 patients with head and neck cancer who are enrolled in employer-sponsored UnitedHealthcare (UHC) plans will participate in the pilot.
“For the last five years, MD Anderson and its Institute for Cancer Care Innovation have been looking at how to best approach a single price for treating cancers. It is a complex question because cancer is a complex disease and each patient unique,” stated Thomas W. Feeley, M.D., Head of Anesthesiology and Critical Care, and Head of the Institute, in an MD Anderson news release. “Bundled pricing is something that patients and care providers want, and this is our first opportunity to better understand how we can manage costs without sacrificing quality care and patient outcomes.” (more…)
Dec 8, 2014 | Compliance, Legal, and Malpractice, Laboratory Hiring & Human Resources, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology
College of American Pathologists and associations for family physicians and ob-gyns in Florida have asked UnitedHealthcare to discontinue implementation of BeaconLBS system
Medical laboratory testing is at the center of a contest of wills in Florida. On one side is a health insurer that wants to require physicians to obtain pre-notification or preauthorization for a list of clinical laboratory tests. On the other side are the physicians who question the clinical basis for these requirements and the time and resources required to comply with the health insurer’s program.
This rancorous dispute is in reaction to the laboratory benefit management program created by UnitedHealthcare (NYSE: UNH) (UHC) administered by BeaconLBS, a business division of Laboratory Corporation of America (NYSE: LH) (LapCorp). (more…)
Oct 11, 2013 | Instruments & Equipment, Laboratory News, Laboratory Operations, Laboratory Pathology, Management & Operations
Predictions are that more disease-prevention programs will be developed, creating the opportunity for laboratories to be more proactive in helping clinicians keep patients well
Pathologists and clinical laboratory managers take note! The Centers for Disease Control and Prevention (CDC) is accumulating a growing body of evidence that its community-based diabetes prevention program is effective at improving the health of participating patients.
These auspicious findings may encourage a steep increase in the number and type of disease-prevention programs. In turn, greater deployment of such programs could further accelerate healthcare’s shift away from a reactive treatment of disease model to a proactive disease prevention model of care.
Such developments would be favorable for medical laboratories and pathology groups. As physicians pay more attention to diagnosing disease at earlier stages, they will want to tap the expertise of pathologists, Ph.D.s, and laboratory scientists. (more…)
Sep 16, 2013 | Coding, Billing, and Collections, Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Laboratory Sales and Marketing, Management & Operations, News From Dark Daily
Clinical laboratories and pathology groups serving Cigna beneficiaries can expect to see new requirements for genetic tests used to diagnose breast cancer, colon cancer and long QT syndrome
Effective this week, Cigna (NYSE: CI) in Bloomfield, Connecticut, is implementing a new program that requires genetic counseling and pre-authorization for certain genetic tests. This is an important development and clinical laboratory executives can expect to see other health insurers take similar steps.
Cigna wants to control costs and improve the appropriateness of ordering expensive genetic tests. It will start with tests for three conditions and may require counseling for other types of genetic tests if this program is successful. Industry observers expect other health insurers will follow Cigna’s example and also require genetic counseling for a compelling reason: all insurers recognize that more than 50% of all genetic tests may be ordered inappropriately, experts say.
(more…)
Nov 23, 2012 | Laboratory Hiring & Human Resources, Laboratory News, Laboratory Pathology
Hot competition for genetic testing market share is a signal to medical laboratories to ramp up their molecular and genetic testing capabilities
Financial analysts see something of an “old west” style shootout on the horizon for genetic testing in the clinical laboratory testing market. Market leaders in next-generation gene sequencing are prepared to use acquisitions to build dominant shares in a gene testing market that experts say could hit $25 billion by 2022.
Reporters at Bloomberg Businessweek believe that San Diego-based Illumina, Inc. (NASDAQ: ILMN) is girding up to take on industry giant Roche Holding AG (ROG.VX). Both Illumina and Life Technologies Corp. (NASDAQ:LIFE) are buying up smaller players in the gene testing market.
These two market leaders in DNA sequencing equipment have played important roles in revolutionizing genetic testing. Now, they intend to stake out a share of the fast-growing genetic diagnostics market themselves, a recent Businessweek story reported. (more…)
