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       Headlines - September 6, 2011
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R. Lewis Dark: Healthcare Reform and Laboratory Testing

WE ARE ONLY 120 days from Implementing another round of programs mandated by the Patient Protection and Affordable Care Act (PPACA) of 2010 and associated legislation. Certain programs become effective on January 1, 2012.

On that date, the transition to HIPAA form 5010 (See Dark Daily HIPAA 5010 Audio Recordings) takes effect. All clinical laboratories and pathology groups should be prepared for this step. Use of this form by providers and payers is a necessary step if the scheduled implementation of ICD-10 codes in 2013 is to prove successful.

Effective on January 1, 2012, the Centers for Medicare and Medicaid Services (CMS) can begin contracting with accountable care organizations (ACO). CMS issued a draft of the rules for this program earlier this year. National associations for hospitals and physicians responded with plenty of criticism about the proposed language of these rules. Nonetheless, CMS will be taking forward steps to begin contracting with ACOs after the New Year.

Another significant program that launches during 2012 is medicare's value-based purchasing (vBP) program for hospitals. It becomes effective on October 1, 2012. This is an important reform because it represents a major effort to begin evolving the existing fee-for-service system towards a reimbursement model that rewards providers for improving outcomes across an identified population of patients that meet or exceed pre-established targets.

Of course, I don't need to tell you that, at the same time thatmajor efforts to reformhealthcare like those described above are happening, themarketplace for clinical laboratory and pathology testing continues to evolve at its own rapid pace. New buyers are flooding into the market looking for lab companies they can buy, for example. Of course, specialist physicians continue to open their own in-clinic pathology laboratories, thus reducing the access to specimens for many community hospital-based pathology groups. (See pages 3-8.)

Taken collectively, these events cannot be ignored by pathologists and lab administrators tasked with developing the strategies their lab organizations need to deliver state-of-the-art lab testing services in a financially sustainable manner. The lab testing profession is about to enter a new cycle of accelerated health reform initiatives. That makes it imperative that every lab organization remain nimble and open to smart changes in response to these developments.

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How In-Clinic Path Lab Benefits GI Practice

Specialist physicians value shorter test TAT, more access to pathologists, and added revenue

CEO SUMMARY: In Manassas, Virginia, a five-physician gastroenterology group is using its in-clinic anatomic pathology laboratory to advance patient care, while boosting revenue associated with this ancillary service. In this exclusive interview, the group's physician business leader shares the different ways that this inhouse pathology service benefits both patients and physicians. Patients like the faster turnaround times for reports and doctors like the close clinical consultations with their pathologists.

AP Labs in Doc's Clinics Now an Established Fact

Urology and gastroenterology groups value having an in-clinic anatomic pathology service

CEO SUMMARY: It started about eight years ago and shows no signs of slowing down. Specialist physicians, particularly urolo- gists and gastroenterologists, have learned about the benefits of operating their own in-clinic anatomic pathology laboratories. One-by-one, these specialty practices are investing in this ancillary service. As they do, local pathology groups lose access to these tis- sue referrals. This major shift in the pathology marketplace gives many indications that is a trend that wonít be reversed.

The Dark Index: Sonic Healthcare Ltd., Reports Full Year Earnings For FY 2011

Australian-based laboratory company now holds third largest share of docís office referral tests in U.S.

NEWSMAKER INTERVIEW: How Digital Pathology Helps Pathologists Deliver Added Value

Recovery audit Recovery audit contractors (RAC) visiting pathology labs and groups

CEO SUMMARY: During the 1990s, the pathology profession was exploring ways to use telepathology services. But it was only in the last decade when digital pathology technology became robust enough to support a variety of clinical uses in anatomic pathology. One of the first companies to offer such digital pathology systems was Aperio Technologies, Inc., of Vista, California. Dirk G. Soenksen, M.S., M.B.A., is the Founder and CEO of Aperio. In this exclusive interview with THE DARK REPORT, he discusses major trends in healthcare that are actively reshaping the anatomic pathology profession. In part one of this two- part interview, Soenksen provides insights that will help pathologists and pathology group practice administrators develop effective clinical and financial strategies for their laboratories.

MARKET STRATEGIES: Rhode Island Lab Educates Consumers about Laboratory Prices

Canadian Journal of Pathology published a study of factors affecting supply and demand

Georgia HIE Helps All Labs Feed Test Data to Docs

Lab hub will interface to physicians' EHRs to support lab orders and lab results reporting

CEO SUMMARY: In Macon, Georgia, an innovative effort by a k regional extension center and a health information exchange (HIE) will level the playing field for hospital labs and independent labs in the state. Their goal is to build a secure and flexible clinical inte- gration platform known as a "lab hub." This common interface will allow all physicians in the network to use their electronic health record (EHR) systems to order lab tests and receive structured lab test results directly into a patient's health record. (The Central Georgia Health Network (CGHN) and the Georgia Health IT Regional Extension Center (GA- HITREC) have teamed up with Halfpenny Technologies, Inc.)



TRANSITIONS: Effective September 1, 2011, James C. New retired as CEO of Aurora Diagnostics Holdings, LLC.

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