Impact of Managed Care on Laboratory Economics

Clinical laboratory economics has been transformed by the exclusive contracting practices and capitated reimbursement of managed care companies. Although the short-term results have been disruptive, managed care's inherent need for predictability in utilization and charge estimates provides a new opportunity for the clinical laboratory to participate in patient care. As steward of ICD-9-CM (International Classification of Diseases, Clinical Modification, 9th revision) codes and experts in process control, the clinical laboratory can take a leadership role in utilization, cost, and outcomes management within its medical community