We’ve talked much about the providers, patients, and labs we serve, but payers — and how we deal with, navigate, and partner with them — are also a critical part of the equation. We asked laboratory outreach leader Dr. Kathy Murphy to comment on how she sees the future of hospital lab networking; that is, hospital labs within the same health system collaborating with other non-affiliated hospital labs to negotiate managed care contracts with private payers to be considered in-network for outpatients.
Kathy Murphy, PhD — Chief Executive Officer at Chi Solutions
I’m aware of some hospital-based networks that have been very successful in leveraging their strengths with managed care. I think one of the earliest ones that everyone’s familiar with is the Joint Venture Hospital Laboratory network in Michigan. I mean, they have ridden Quest and Lab Corp completely out of the state as a result of that. There are others in the Pennsylvania area, there’s some in the Rocky Mountains in Colorado and others. It’s a very viable model.
I can tell you from my practical experience that this whole issue of access to payer contracts is very often thought to be a real limit to outreach, but in most cases it’s not. In fact, I wrote a blog post about this that has become probably the most popular blog on our website. It’s called “The Myth of National Lab Exclusivity.” It’s a real tongue-in-cheek cartoon about how the national labs tell everybody that they’re the only ones who can do certain work for certain insurance companies when in fact, it’s not the case. I mean, they might have a preferential price, but every hospital has contracts with United Healthcare, Cigna, Anthem, and some of these others that are trying to play these tricks. So, I encourage you to look at that if you think you’re stymied by that issue.
“This whole issue of access to payer contracts is very often thought to be a real limit to outreach, but in most cases it’s not.”
To read more of Kathy’s insights into the future of laboratory outreach, download “Where Do We Go From Here? Laboratory Outreach in a Value-Based Era“.