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.