Will Health Plans Kill the Laboratory Outreach Program

Across the US, many community-based laboratories are experiencing erosion of their outreach program volumes and revenue. This erosion is largely due to the lack of access to insurance contracts and/or aggressive steerage campaigns launched by insurance companies. Health plans are directing laboratory outreach testing to “in-network” laboratories, and as patients become more educated about healthcare costs, the role of payer contracting for outreach laboratory testing will increase.

How can a community-based laboratory compete with larger entities when health plans are cost-conscious and consumers have commoditized testing? Is there differentiation beyond test cost, and how can laboratories convey this value to payers? This session will highlight strategies that community-based laboratories can use to overcome local and regional challenges related to health plan contracting.

Learning Objectives

  • Describe emerging payer trends in today’s healthcare environment
  • Identify ways that health plan contracts impact the laboratory outreach program and influence patient choice
  • Recognize alternative solutions to achieve payer contracting success and continued outreach program growth

Continuing Education
1.5 Continuing Education Unit

Body of Knowledge Learning Domains

  • Governance and Organizational Dynamics

Content Level

  • Advanced


  • $29 for Members
  • $49 for Non-Members

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