Biopsy Client Database for Pathologists

Biopsy Client Database for Pathologists

Biopsy Client Database for Pathologists

Laboratory Economics is offering a database of 50,000+ specialty physicians and ambulatory surgery centers that perform biopsies that lead to pathology referrals. The database includes annual Medicare Part B biopsy volumes for 2019 plus estimated overall biopsy volumes for each provider for 2021.

The database comes in easy-to-use and searchable Excel spreadsheets. It includes detailed biopsy volume figures for seven key specialty physician categories, including Breast Cancer (4,000+ providers), Cervix (600+ providers), Dermatology (18,000+ providers), FNA Biopsies (3,900+ providers), Gastroenterology/Colorectal (20,000+ providers), Urology/
Prostate (5,500+ providers) and Lung (2,000+ providers).

THE DATA IS PRESENTED IN A USER-FRIENDLY EXCEL SPREADSHEET AND INCLUDES:

• National Provider Identifier (NPI)
• Provider Name
• Address
• Specialty (Breast, Cervix, Dermatology, FNA Biopsies, Gastro/Colorectal,          Lung and Urology/Prostate)
• Specific Annual Medicare Biopsy Volume by CPT Code (2019)
• Overall Annual Biopsy Volume Estimates (2021)

PROVIDE YOUR SALES REPS WITH THE DATA THEY NEED TO SUCCEED! • Data for all 50 states and Puerto Rico
• Find new biopsy referral clients to grow your sales
• Create targeted lists by location or specialty to focus on your best opportunities
• Identify underserved markets for geographic expansion
• Save time and money by using accurate, complete and consistent data

Tips For Negotiating Your Lab’s Next Reference Testing Contract

Tips For Negotiating Your Lab’s Next Reference Testing Contract

Tips For Negotiating Your Lab’s Next Reference Testing Contract

Reference (aka send-out) testing expenses average between 5% and 10% of the overall budget at most hospital laboratory departments. “Everybody thinks they are getting a good deal, but most have not wrung out the lowest prices available from their reference lab,” notes Steve Mattice,
President of the hospital lab consulting firm J.A. Mattice & Associates (Portland, OR). Below we highlight some of Mattice’s key tips and observations.

What’s the “hot list” in terms of send-out tests?
This is the list of 10 to 100 higher-volume send-out tests that the big reference labs (ARUP, Labcorp, Mayo and Quest Diagnostics) will discount the most in order to win a contract. But it’s a diversion because they offset their lower prices on the recognizable tests with much higher prices on lower-volume send-out tests. Each of the major reference labs is most focused on the overall profitability of their reference testing contracts.

How can hospitals negotiate for the best overall reference testing contract?
The key is knowing the lowest price that the major reference labs are willing to provide for each specific send-out test. We have helped negotiate more than 100 reference testing contracts over the past 30 years and have maintained a database of the lowest prices we have found for send-out tests from the four largest reference labs. Every time we find a lower price for the same test code, we keep track of it, and it becomes our new standard price for negotiations. When negotiating a new send-out testing contract, we will typically analyze the total annual costs for all send-out tests at a hospital client.

What kind of pricing variation is there?
There is a wide variation (see table). For example, we have found that some hospitals pay their reference lab as little as $9 for Lyme Disease Antibody tests (CPT 86618), while others pay as high as $101. It’s not like shopping at the supermarket where you can easily compare prices. In reference testing, like most of healthcare, nobody knows what the other guy is charging.

What kind of savings are you typically able to achieve?
Historically, we have averaged in the range of 23% to 27% savings for each new three-year reference testing contract. However, over the past year, labs have begun to experience inflationary pressure on wages, reagents, paper supplies, courier services, etc. As a result, we’ve started to see the big reference labs draw a harder line on pricing.

Have there been any new entrants in reference testing to challenge the “big four?”
There are a handful of large health systems and academic medical centers competing on a regional basis and Sonic Reference Laboratory has been making some inroads into the market over the past few years.

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America’s Fastest-Growing Labs

America’s Fastest-Growing Labs

America’s Fastest-Growing Labs

Phlebxpress (Temecula, CA) grew its Medicare Part B test service volume by 202% per year between 2015 and 2018, making it the fastest-growing independent lab company in America over the three-year period. Phlebxpress is a mobile phlebotomy company headquartered in Southern California that serves California, Nevada, and Texas. Its highest volume Part B test services included travel allowance (P9603 & P9604) and routine venipuncture (CPT 36415).

Two other mobile phlebotomy companies, Mobile Health Labs (Orlando, FL), up 63% per year, and Unique Lab Services (Fountain Hills, AZ), up 59% per year, rounded out the top three.

Two hospital-owned outreach labs, UCLA Outreach Clinical Lab (Panorama City, CA) and Pathology Laboratory (Ankeny, IA), owned by UnityPoint Health, were also among the fastest-growing lab companies.

Overall, some 2,900 independent clinical labs saw their Medicare Part B volume decline from 352.6 million test services in 2015 to 314.2 million test services in 2018. The decline was mostly driven by the introduction of new bundled codes for drug testing (G0480-G0483), which eliminated a large volume of individually billed drug tests.

Top 25 Fastest-Growing Labs by Medicare Part B Volume of Services

LabCorp Reports Full-Year 2019 Financial Results

LabCorp Reports Full-Year 2019 Financial Results

LabCorp Reports Full-Year 2019 Financial Results

LabCorp (Burlington, NC) reported net income of $823.8 million for the full-year 2019, down from $883.7 million in 2018. LabCorp’s overall revenue increased by 2.0% to $11.6 billion in 2019.

Revenue from LabCorp’s lab testing business decreased by 0.4% to $7 billion in full-year 2019. This year LabCorp expects its lab testing business to increase its revenue by 0.5% to 2.5%. This guidance includes a -1.3% impact from PAMA and -0.9% from UnitedHealth’s nonrenewal of the BeaconLBS contract in Florida.

LabCorp expects revenue from its Covance Drug Development division to grow by 7% to 9.5% in 2020.

On February 13, LabCorp held a conference call with analysts and investors. Here are some comments on a few key topics from CEO Adam Schechter.

Impact from PAMA
Schechter said that the PAMA rate cuts reduced the company’s lab testing revenue by approximately $100 million in 2019. He expects a similar $100 million revenue loss from PAMA this year and again in 2021.

UnitedHealth’s Preferred Laboratory Network (PLN)
“I don’t assume there’ll be a significant shift [to PLN labs] in 2020 because they’re rolling it out as we speak….If it works for United, I think that other organizations may see this as an opportunity to help them reduce their laboratory costs by moving over business to a lab like ours.”

Hospital Lab Acquisitions
“As I look at the hospital tuck-in acquisitions, I can tell you that our list is long. There are many discussions that we’re having around the country with both local and regional labs and hospitals… I believe over time it [hospital lab deals] will begin to accelerate, particularly as they feel the continued impact from PAMA.”

Direct to Consumer Genetic Testing
“We saw a significant decline in 2019 versus 2018. It’s now a very small amount of our total volume and of our total revenue and operating income.” Laboratory Economics notes that LabCorp has had a contract to provide genotyping services to 23andMe Inc. (Sunnyvale, CA) since 2008. After years of strong demand for
its ancestry and health testing services, 23andMe recently laid off 100 employees, or 14% of its workforce, citing a slowdown in consumer demand.

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Laboratory Economics Issues Research Report on U.S. Anatomic Pathology Market

Laboratory Economics Issues Research Report on U.S. Anatomic Pathology Market

Laboratory Economics Issues Research Report on U.S. Anatomic Pathology Market

The publisher of Laboratory Economics has just released The U.S. Anatomic Pathology Market: Forecast & Trends 2019-2021. With this special report, you can tap into 150 pages of proprietary market research that reveals critical data and information about key business trends affecting the anatomic pathology market.

The report reveals that the anatomic pathology market (including Pap testing) now represents an estimated $18 billion of revenue with an annual growth rate of 3-4%. All data and trends are fully explained throughout the report, including 10-year historical data and a detailed three-year forecast.

The U.S. anatomic pathology market endured intense reimbursement pressure between 2013 and 2017. “However, the Medicare program has completed its evaluation of payment rates for all the key pathology codes and the reimbursement environment now appears stable,” according to Jondavid Klipp, Publisher of Laboratory Economics. “Furthermore, the introduction of new higher-priced molecular oncology tests linked to targeted cancer drugs is driving volume trends higher. As a result, the outlook for the U.S. anatomic pathology market is the best it’s been in the past 10 years.”

The report includes:

  • More than 100 charts and graphs
  • Industry size and growth rates
  • Detailed estimates for market subsets like prostate cancer testing, dermatopathology, lymphoma/leukemia and gastrointestinal
    pathology
  • Medicare claims data for 60 key pathology codes
  • Cervical cancer testing trends and pricing data
  • In-office histology lab trends
  • Detailed analysis of the digital pathology market
  • Results from Laboratory Economics’ exclusive Anatomic Pathology
    and Clinical Lab Trends Surveys from 2007 through 2019

Anatomic pathology companies featured in this report include: Aurora Diagnostics, Bako Diagnostics, CellNetix Labs, Exact Sciences, Genomic Health, InformDX, LabCorp/Dianon, Myriad Genetics, Mayo Clinic Labs, NeoGenomics, OPKO/BioReference Labs, PathGroup, Pathology Reference Laboratory, Poplar Healthcare, ProPath Services, Quest Diagnostics/AmeriPath and Sonic Healthcare USA.

The U.S. Anatomic Pathology Market: Forecast & Trends 2019-2021 is published by Laboratory Economics (www.laboratoryeconomics.com), an independent market research firm focused exclusively on the business of pathology and laboratory medicine.

Contact Information
Contact: Jondavid Klipp, President
Laboratory Economics
195 Kingwood Park
Poughkeepsie, NY 12601
Phone: 845-463-0080
www.laboratoryeconomics.com

Technical Rates for Many Pathology Services To Get Small Boost Under Proposed MPFS

Technical Rates for Many Pathology Services To Get Small Boost Under Proposed MPFS

The Proposed Medicare Physician Fee Schedule (MPFS) for 2020 includes a 5% hike to the technical component for CPT 88305, which, if finalized, would raise it to $32.12. Meanwhile, the rate for the professional interpretation is being lowered by a proposed 1% to $39.34. Overall, the global rate for CPT 88305 will increase by a proposed 2% to $71.46.

In general, technical component fees for many key surgical pathology
services (e.g., CPT 88305, 88307 and 88309) and special stains (e.g., CPT
88312 & 88313) are proposed to increase, while most professional interpretation rates are set for no change or small reductions.

Meanwhile, a few areas where pathologists and labs will see significant
rate reductions are cytopathology, flow cytometry and prostate biopsies.