Top 20 Medi-Cal Laboratories

by Jondavid Klipp | Jun 15, 2019 | Laboratory Market Research, Medi-Cal

Top 20 Medi-Cal Laboratories

The largest Medi-Cal lab provider is The Genetic Disease Screening Program (GDSP) of the California Department of Health, which received $29.5 million of Medi-Cal FFS payments in calendar year 2018, according to the latest available data from DHCS. The Genetic Disease Screening Program provides prenatal and newborn testing services to Medi-Cal recipients.

Quest Diagnostics is second largest, with $29.4 million of Medi-Cal FFS payments. Planned Parenthood, which tests for sexually transmitted diseases, received $24.7 million, followed by LabCorp at $8.8 million.

The largest academic medical centers and hospital outreach labs on the list are Dignity Health, with $3.3 million of payments, followed by Children’s Hospital of Los Angeles, $2.5 million, and Loma Linda University, $2.2 million.
In total, the top 20 lab organizations collected $127.9 million of Medi-Cal lab test payments for FFS patients in 2018.

Special New Year’s Report: Lab Execs Share Outlook for 2019

by Jondavid Klipp | Jan 14, 2019 | Laboratory Economics, Laboratory Market Research, Laboratory Outlook

Special New Year’s Report: Lab Execs Share Outlook for 2019

For an inside look at what may be in store for the clinical lab and pathology business this year, Laboratory Economics interviewed the top executives at a diverse group of 10 lab companies.

Not surprisingly, our interviews revealed that commercial insurers are using Medicare’s repricing of the CLFS as a pretext to cut their own rates. What is surprising (and alarming) is that some commercial insurers have demanded the full three-year phased-in ~30% CLFS reduction applied to their rates upfront immediately.

Labs are hoping to offset the pricing pressure by gaining economies of scale through geographic and test menu expansion. On the brighter side, the extreme pricing pressure that terrorized technical services for anatomic pathology seems to be over. Furthermore, molecular diagnostics and prescription drug monitoring continue to be high-growth markets.

Pricing pressure from both Medicare and commercial insurers
High volume growth in molecular diagnostics and prescription drug monitoring
Anatomic pathology reimbursement rates have stabilized
Hospital outreach labs benefiting from health system acquisitions of physician practices
Nursing home labs are restructuring and consolidating

Companies profiled in the January 2019 issue of Laboratory Economics include Sonic Healthcare USA, NeoGenomics, Health Network Laboratories, CellNetix, TriCore Reference Labs, Enzo Clinical Labs, Clinical Laboratory Services, CellMax Life, Psychemedics and Wisconsin Diagnostic Labs.