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The physician office laboratory: profitability under managed care
1American Association of Physician Office Laboratories, Knoxville, TN 37933, USA.
Medical Group Management Journal
|December 8, 1996
Summary
Physician office laboratories face closure due to CLIA regulations and managed care restrictions. To remain viable, labs must enhance quality, customer satisfaction, and cost-effectiveness before negotiating with managed care organizations (MCOs).
Area of Science:
- Clinical laboratory science
- Healthcare management
Background:
- Clinical Laboratory Improvement Amendments (CLIA) regulations have led to the closure of many physician office laboratories.
- Managed care organizations (MCOs) further restrict laboratory services by limiting reimbursement for in-house procedures.
Purpose of the Study:
- To identify strategies for physician office laboratories to counteract the trend of closure and restrictions imposed by managed care.
- To outline a framework for making physician office laboratories more attractive to MCOs.
Main Methods:
- The study discusses the impact of CLIA and managed care on physician office laboratories.
- It proposes a strategic approach for laboratory financial and operational improvement.
Main Results:
- Physician office laboratories must focus on quality, customer satisfaction, and cost-effectiveness to appeal to MCOs.
- Discounting laboratory fees is a key component of the proposed strategy.
Conclusions:
- Emphasizing quality, customer satisfaction, and cost-effectiveness can make physician office laboratories more competitive.
- Successful negotiation with MCOs requires a strong value proposition, including competitive pricing.