Rampant Pathology Insourcing - Seems Bad

[futuredoc15]

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My dad is a pathologist and he showed me this:
NEW IN-OFFICE HISTOLOGY LABS
Associates in Gastroenterology (Manassas, VA) recently opened its own histology lab. The group is preparing slides and has contracted with a local pathologist at a negotiated fee for professional services. The group is billing for global pathology services, including immunohistochemistry and special stains. The group has five gastroenterologists and two physician assistants. Estimated annual pathology service revenue is $600,000.
Somerset Urological Associates (Somerville, NJ) opened a histology lab in May. The group, which has four urologists, has contracted with Anthony D’Aguillo, MD, for slide interpretations. The group is billing globally and will generate estimated annual revenue of $600,000 from pathology services.
Mount Kisco Medical Group (Mount Kisco, NY) opened a new anatomic pathology lab last summer. This multi-specialty group hired two full-time pathologists from Quest Diagnostics. Kim Ruska, MD, is former director of dermatopathology for Quest’s lab in Teterboro, New Jersey. Barbara Winkler, MD, is former associate director for gynecological pathology. MKMG has about 200 physicians, including four urologists and seven gastroenterologists, in 20 different offices in Westchester, Putnam and Dutchess counties. Estimated annual pathology service revenue is $2+ million.
Lancaster Gastroenterology (Lancaster, PA) opened a histology lab in May 2009. The group has hired a full-time pathology assistant and contracts with Fabien Baksh, MD, at Pennsylvania Specialty Pathology (Lancaster) for professional services. Lancaster Gastroenterology has eight gastroenterologists. Estimated annual pathology service revenue is $1 million.

75 Specialty Groups That Have Insourced Anatomic Pathology
The table below shows 75 specialty groups that have opened in-office histology labs over the past five years. In total, these groups represent 1,381 physicians and $150 million in annual anatomic pathology revenue.
Name of Group.........................................................................................................# Physicians
Advanced Urology Associates of Florida (Vero Beach, FL)................................................................2
Alliance Urology (Greensboro, NC)...............................................................................................12
Arizona Digestive Health (Phoenix, AZ)........................................................................................39
Arkansas Urology (Little Rock, AR)...............................................................................................17
Asheville Gastroenterology Associates (Ashville, NC).....................................................................17
Associated Urological Specialists (Orland Park, IL)........................................................................16
Associates in Gastroenterology (Manassas, VA)................................................................................5
Atlanta Gastroenterology (Atlanta, GA).........................................................................................50
Atlantic Urological Associates (DeLand, FL)..................................................................................14
Austin Gastroenterology (Austin, TX)............................................................................................21
Bergen Urological Associates (Hackensack, NJ)...............................................................................3
California Skin Institute (San Jose, CA).........................................................................................11
Capital Region Urological Services (Albany, NY)...........................................................................15
Cary Gastroenterology Associates (Cary, NC)..................................................................................6
Center for Digestive Care (Saint Petersburg, FL)..............................................................................4
Center for Gastroenterology (Fort Collins, CO)............................................................................14
Central Ohio Urology Group (Columbus, OH)............................................................................25
Chesapeake Urology Associates (Baltimore, MD)...........................................................................48
Community Care Physicians/Urological Institute (Albany, NY).....................................................10
Coral Ridge Gastroenterology Associates (Overland Park, FL).........................................................5
Delaware Valley Urology (Marlton, NJ).........................................................................................35
Desert Gastro Consultants (Rancho Mirage, CA)............................................................................3
Digestive Disease Specialists of Northeast Alabama (Gadsden, AL)..................................................5
Digestive Health Associates of Texas (Dallas, TX)..........................................................................73
Digestive Health Center of Louisiana (Baton Rouge, LA)..........................................................15
Digestive Health Specialists (Tacoma, WA)................................................................................18
Eugene Gastroenterology Consultants (Eugene, OR)...................................................................8
Florida Foot and Ankle Associates (Doral Beach, FL)................................................................32
Gastroenterology Associates of Cleveland (Cleveland, OH).........................................................5
Gastroenterology Associates of Pensacola (Pensacola, FL)..........................................................10
Gastroenterology Associates (Garden City, NJ)............................................................................7
Gastroenterology Associates of Suffolk (Smithtown, NY)............................................................4
Gastroenterology Center of Connecticut (Hamden, CT)...........................................................13
Gastroenterology Consultants (Reno, NV)................................................................................17
Gastroenterology Consultants of South Jersey (Lumberton, NJ)..................................................7
Gastroenterology Specialties (Lincoln, NE).................................................................................8
Gastro-Intestinal Associates (Lima, OH).....................................................................................4
Gastrointestinal Associates (Overland Park, KS)..........................................................................9
Gastrointestinal Associates of North Texas (Fort Worth, TX).....................................................16
Gastroenterology Group Inc. (Akron, OH).................................................................................4
Genito-Urinary Surgeons (Toledo, OH)....................................................................................11
Hudson Valley Urology (Poughkeepsie, NY)................................................................................9
Lancaster Gastroenterology (Lancaster, PA).................................................................................8
Metro Urology (St. Paul, MN)..................................................................................................25
Metropolitan Urologic Specialists (St. Louis, MO)....................................................................17
Michigan Institute of Urology (Detroit, MI).............................................................................27
Midwest Gastrointestinal Associates (Omaha, NE)....................................................................18
Minnesota Gastroenterology (Minneapolis, MN)......................................................................50
Mount Kisco Medical Group (Mount Kisco, NY)...................................................................200
New York Urological Associates (New York City)......................................................................11
Ohio Gastroenterology Group (Columbus, OH).......................................................................23
Pioneer Valley Urology (Springfield, MA)....................................................................................9
Shore Gastroenterology Associates (Oakhurst, NJ)......................................................................6
Somerset Urological Associates (Somerville, NJ)..........................................................................4
Southeast Texas Gastroenterology Associates (Beaumont, TX).....................................................5
Southwest Florida Urologic Assoc. (Fort Myers, FL)....................................................................8
Texas Digestive Disease Consultants (Dallas, TX)......................................................................30
The Urology Center of Colorado (Denver, CO)........................................................................14
The Urology Group (Cincinnati, OH)......................................................................................34
Triangle Urology (Durham, NC).................................................................................................6
Troy Gastroenterology (Troy, MI)................................................................................................8
Urology Associates (Manhasset, NY)...........................................................................................8
Urology Associates of North Texas (Dallas, TX).........................................................................50
Urology Consultants (Saint Louis, MO)....................................................................................10
Urology Group of Western New England (Springfield, MA)........................................................5
Urology Health Specialists (Philadelphia, PA)............................................................................15
Urology of Indiana (Greenwood, IN)........................................................................................30
Urology Partners (Bradenton, FL)...............................................................................................6
Urologic Specialties of New England (West Warwick, RI)...........................................................8
UroPartners LLC (Chicago, IL).................................................................................................38
Village Podiatry Group (Smyrna, GA).......................................................................................22
Virginia Urology (Richmond, VA).............................................................................................25
Wake Gastroenterology (Raleigh, NC)........................................................................................4
Wayne B. Glazier, MD, Urology (Worcester, MA).......................................................................3
Wilmington Gastroenterology Associates (Wilmington, NC)......................................................7
Total Urologists..............................................................................................................570
Total Gastroenterologists................................................................................................546
Total Other Physicians...................................................................................................265
Total Physicians.............................................................................................................1,381
Total Estimated AP Revenue per Year................................................................$150+ million

 

[KeratinPearls]

My dad is a pathologist and he showed me this:
NEW IN-OFFICE HISTOLOGY LABS
Associates in Gastroenterology (Manassas, VA) recently opened its own histology lab. The group is preparing slides and has contracted with a local pathologist at a negotiated fee for professional services. The group is billing for global pathology services, including immunohistochemistry and special stains. The group has five gastroenterologists and two physician assistants. Estimated annual pathology service revenue is $600,000.
Somerset Urological Associates (Somerville, NJ) opened a histology lab in May. The group, which has four urologists, has contracted with Anthony D'Aguillo, MD, for slide interpretations. The group is billing globally and will generate estimated annual revenue of $600,000 from pathology services.
Mount Kisco Medical Group (Mount Kisco, NY) opened a new anatomic pathology lab last summer. This multi-specialty group hired two full-time pathologists from Quest Diagnostics. Kim Ruska, MD, is former director of dermatopathology for Quest's lab in Teterboro, New Jersey. Barbara Winkler, MD, is former associate director for gynecological pathology. MKMG has about 200 physicians, including four urologists and seven gastroenterologists, in 20 different offices in Westchester, Putnam and Dutchess counties. Estimated annual pathology service revenue is $2+ million.
Lancaster Gastroenterology (Lancaster, PA) opened a histology lab in May 2009. The group has hired a full-time pathology assistant and contracts with Fabien Baksh, MD, at Pennsylvania Specialty Pathology (Lancaster) for professional services. Lancaster Gastroenterology has eight gastroenterologists. Estimated annual pathology service revenue is $1 million.

75 Specialty Groups That Have Insourced Anatomic Pathology
The table below shows 75 specialty groups that have opened in-office histology labs over the past five years. In total, these groups represent 1,381 physicians and $150 million in annual anatomic pathology revenue.
Name of Group.........................................................................................................# Physicians
Advanced Urology Associates of Florida (Vero Beach, FL)................................................................2
Alliance Urology (Greensboro, NC)...............................................................................................12
Arizona Digestive Health (Phoenix, AZ)........................................................................................39
Arkansas Urology (Little Rock, AR)...............................................................................................17
Asheville Gastroenterology Associates (Ashville, NC).....................................................................17
Associated Urological Specialists (Orland Park, IL)........................................................................16
Associates in Gastroenterology (Manassas, VA)................................................................................5
Atlanta Gastroenterology (Atlanta, GA).........................................................................................50
Atlantic Urological Associates (DeLand, FL)..................................................................................14
Austin Gastroenterology (Austin, TX)............................................................................................21
Bergen Urological Associates (Hackensack, NJ)...............................................................................3
California Skin Institute (San Jose, CA).........................................................................................11
Capital Region Urological Services (Albany, NY)...........................................................................15
Cary Gastroenterology Associates (Cary, NC)..................................................................................6
Center for Digestive Care (Saint Petersburg, FL)..............................................................................4
Center for Gastroenterology (Fort Collins, CO)............................................................................14
Central Ohio Urology Group (Columbus, OH)............................................................................25
Chesapeake Urology Associates (Baltimore, MD)...........................................................................48
Community Care Physicians/Urological Institute (Albany, NY).....................................................10
Coral Ridge Gastroenterology Associates (Overland Park, FL).........................................................5
Delaware Valley Urology (Marlton, NJ).........................................................................................35
Desert Gastro Consultants (Rancho Mirage, CA)............................................................................3
Digestive Disease Specialists of Northeast Alabama (Gadsden, AL)..................................................5
Digestive Health Associates of Texas (Dallas, TX)..........................................................................73
Digestive Health Center of Louisiana (Baton Rouge, LA)..........................................................15
Digestive Health Specialists (Tacoma, WA)................................................................................18
Eugene Gastroenterology Consultants (Eugene, OR)...................................................................8
Florida Foot and Ankle Associates (Doral Beach, FL)................................................................32
Gastroenterology Associates of Cleveland (Cleveland, OH).........................................................5
Gastroenterology Associates of Pensacola (Pensacola, FL)..........................................................10
Gastroenterology Associates (Garden City, NJ)............................................................................7
Gastroenterology Associates of Suffolk (Smithtown, NY)............................................................4
Gastroenterology Center of Connecticut (Hamden, CT)...........................................................13
Gastroenterology Consultants (Reno, NV)................................................................................17
Gastroenterology Consultants of South Jersey (Lumberton, NJ)..................................................7
Gastroenterology Specialties (Lincoln, NE).................................................................................8
Gastro-Intestinal Associates (Lima, OH).....................................................................................4
Gastrointestinal Associates (Overland Park, KS)..........................................................................9
Gastrointestinal Associates of North Texas (Fort Worth, TX).....................................................16
Gastroenterology Group Inc. (Akron, OH).................................................................................4
Genito-Urinary Surgeons (Toledo, OH)....................................................................................11
Hudson Valley Urology (Poughkeepsie, NY)................................................................................9
Lancaster Gastroenterology (Lancaster, PA).................................................................................8
Metro Urology (St. Paul, MN)..................................................................................................25
Metropolitan Urologic Specialists (St. Louis, MO)....................................................................17
Michigan Institute of Urology (Detroit, MI).............................................................................27
Midwest Gastrointestinal Associates (Omaha, NE)....................................................................18
Minnesota Gastroenterology (Minneapolis, MN)......................................................................50
Mount Kisco Medical Group (Mount Kisco, NY)...................................................................200
New York Urological Associates (New York City)......................................................................11
Ohio Gastroenterology Group (Columbus, OH).......................................................................23
Pioneer Valley Urology (Springfield, MA)....................................................................................9
Shore Gastroenterology Associates (Oakhurst, NJ)......................................................................6
Somerset Urological Associates (Somerville, NJ)..........................................................................4
Southeast Texas Gastroenterology Associates (Beaumont, TX).....................................................5
Southwest Florida Urologic Assoc. (Fort Myers, FL)....................................................................8
Texas Digestive Disease Consultants (Dallas, TX)......................................................................30
The Urology Center of Colorado (Denver, CO)........................................................................14
The Urology Group (Cincinnati, OH)......................................................................................34
Triangle Urology (Durham, NC).................................................................................................6
Troy Gastroenterology (Troy, MI)................................................................................................8
Urology Associates (Manhasset, NY)...........................................................................................8
Urology Associates of North Texas (Dallas, TX).........................................................................50
Urology Consultants (Saint Louis, MO)....................................................................................10
Urology Group of Western New England (Springfield, MA)........................................................5
Urology Health Specialists (Philadelphia, PA)............................................................................15
Urology of Indiana (Greenwood, IN)........................................................................................30
Urology Partners (Bradenton, FL)...............................................................................................6
Urologic Specialties of New England (West Warwick, RI)...........................................................8
UroPartners LLC (Chicago, IL).................................................................................................38
Village Podiatry Group (Smyrna, GA).......................................................................................22
Virginia Urology (Richmond, VA).............................................................................................25
Wake Gastroenterology (Raleigh, NC)........................................................................................4
Wayne B. Glazier, MD, Urology (Worcester, MA).......................................................................3
Wilmington Gastroenterology Associates (Wilmington, NC)......................................................7
Total Urologists..............................................................................................................570
Total Gastroenterologists................................................................................................546
Total Other Physicians...................................................................................................265
Total Physicians.............................................................................................................1,381
Total Estimated AP Revenue per Year................................................................$150+ million

Thanks for the info. This is terrible. I can't even imagine the profit one group can generate by performing unnecessary biopsies, stains.

 

[2121115]

Unless over-utilization is proved, CMS could care less if they pay a GI doc or a pathologist the TC fee. Also, you don't have to be AP or CP boarded to run a histology lab. The only real way out is to get AP removed from the in office ancillary services exception, which is being worked on now but these things are politically complicated.

 

[pathstudent]

America is a capitalist country what are u going to do about it. The GIs and Uros don't hold a gun to the pathologists heads that sign out their cases.

America is the land of
The free. They hate us because of our freedom.

My dad is a pathologist and he showed me this:
NEW IN-OFFICE HISTOLOGY LABS
Associates in Gastroenterology (Manassas, VA) recently opened its own histology lab. The group is preparing slides and has contracted with a local pathologist at a negotiated fee for professional services. The group is billing for global pathology services, including immunohistochemistry and special stains. The group has five gastroenterologists and two physician assistants. Estimated annual pathology service revenue is $600,000.
Somerset Urological Associates (Somerville, NJ) opened a histology lab in May. The group, which has four urologists, has contracted with Anthony D’Aguillo, MD, for slide interpretations. The group is billing globally and will generate estimated annual revenue of $600,000 from pathology services.
Mount Kisco Medical Group (Mount Kisco, NY) opened a new anatomic pathology lab last summer. This multi-specialty group hired two full-time pathologists from Quest Diagnostics. Kim Ruska, MD, is former director of dermatopathology for Quest’s lab in Teterboro, New Jersey. Barbara Winkler, MD, is former associate director for gynecological pathology. MKMG has about 200 physicians, including four urologists and seven gastroenterologists, in 20 different offices in Westchester, Putnam and Dutchess counties. Estimated annual pathology service revenue is $2+ million.
Lancaster Gastroenterology (Lancaster, PA) opened a histology lab in May 2009. The group has hired a full-time pathology assistant and contracts with Fabien Baksh, MD, at Pennsylvania Specialty Pathology (Lancaster) for professional services. Lancaster Gastroenterology has eight gastroenterologists. Estimated annual pathology service revenue is $1 million.

75 Specialty Groups That Have Insourced Anatomic Pathology
The table below shows 75 specialty groups that have opened in-office histology labs over the past five years. In total, these groups represent 1,381 physicians and $150 million in annual anatomic pathology revenue.
Name of Group.........................................................................................................# Physicians
Advanced Urology Associates of Florida (Vero Beach, FL)................................................................2
Alliance Urology (Greensboro, NC)...............................................................................................12
Arizona Digestive Health (Phoenix, AZ)........................................................................................39
Arkansas Urology (Little Rock, AR)...............................................................................................17
Asheville Gastroenterology Associates (Ashville, NC).....................................................................17
Associated Urological Specialists (Orland Park, IL)........................................................................16
Associates in Gastroenterology (Manassas, VA)................................................................................5
Atlanta Gastroenterology (Atlanta, GA).........................................................................................50
Atlantic Urological Associates (DeLand, FL)..................................................................................14
Austin Gastroenterology (Austin, TX)............................................................................................21
Bergen Urological Associates (Hackensack, NJ)...............................................................................3
California Skin Institute (San Jose, CA).........................................................................................11
Capital Region Urological Services (Albany, NY)...........................................................................15
Cary Gastroenterology Associates (Cary, NC)..................................................................................6
Center for Digestive Care (Saint Petersburg, FL)..............................................................................4
Center for Gastroenterology (Fort Collins, CO)............................................................................14
Central Ohio Urology Group (Columbus, OH)............................................................................25
Chesapeake Urology Associates (Baltimore, MD)...........................................................................48
Community Care Physicians/Urological Institute (Albany, NY).....................................................10
Coral Ridge Gastroenterology Associates (Overland Park, FL).........................................................5
Delaware Valley Urology (Marlton, NJ).........................................................................................35
Desert Gastro Consultants (Rancho Mirage, CA)............................................................................3
Digestive Disease Specialists of Northeast Alabama (Gadsden, AL)..................................................5
Digestive Health Associates of Texas (Dallas, TX)..........................................................................73
Digestive Health Center of Louisiana (Baton Rouge, LA)..........................................................15
Digestive Health Specialists (Tacoma, WA)................................................................................18
Eugene Gastroenterology Consultants (Eugene, OR)...................................................................8
Florida Foot and Ankle Associates (Doral Beach, FL)................................................................32
Gastroenterology Associates of Cleveland (Cleveland, OH).........................................................5
Gastroenterology Associates of Pensacola (Pensacola, FL)..........................................................10
Gastroenterology Associates (Garden City, NJ)............................................................................7
Gastroenterology Associates of Suffolk (Smithtown, NY)............................................................4
Gastroenterology Center of Connecticut (Hamden, CT)...........................................................13
Gastroenterology Consultants (Reno, NV)................................................................................17
Gastroenterology Consultants of South Jersey (Lumberton, NJ)..................................................7
Gastroenterology Specialties (Lincoln, NE).................................................................................8
Gastro-Intestinal Associates (Lima, OH).....................................................................................4
Gastrointestinal Associates (Overland Park, KS)..........................................................................9
Gastrointestinal Associates of North Texas (Fort Worth, TX).....................................................16
Gastroenterology Group Inc. (Akron, OH).................................................................................4
Genito-Urinary Surgeons (Toledo, OH)....................................................................................11
Hudson Valley Urology (Poughkeepsie, NY)................................................................................9
Lancaster Gastroenterology (Lancaster, PA).................................................................................8
Metro Urology (St. Paul, MN)..................................................................................................25
Metropolitan Urologic Specialists (St. Louis, MO)....................................................................17
Michigan Institute of Urology (Detroit, MI).............................................................................27
Midwest Gastrointestinal Associates (Omaha, NE)....................................................................18
Minnesota Gastroenterology (Minneapolis, MN)......................................................................50
Mount Kisco Medical Group (Mount Kisco, NY)...................................................................200
New York Urological Associates (New York City)......................................................................11
Ohio Gastroenterology Group (Columbus, OH).......................................................................23
Pioneer Valley Urology (Springfield, MA)....................................................................................9
Shore Gastroenterology Associates (Oakhurst, NJ)......................................................................6
Somerset Urological Associates (Somerville, NJ)..........................................................................4
Southeast Texas Gastroenterology Associates (Beaumont, TX).....................................................5
Southwest Florida Urologic Assoc. (Fort Myers, FL)....................................................................8
Texas Digestive Disease Consultants (Dallas, TX)......................................................................30
The Urology Center of Colorado (Denver, CO)........................................................................14
The Urology Group (Cincinnati, OH)......................................................................................34
Triangle Urology (Durham, NC).................................................................................................6
Troy Gastroenterology (Troy, MI)................................................................................................8
Urology Associates (Manhasset, NY)...........................................................................................8
Urology Associates of North Texas (Dallas, TX).........................................................................50
Urology Consultants (Saint Louis, MO)....................................................................................10
Urology Group of Western New England (Springfield, MA)........................................................5
Urology Health Specialists (Philadelphia, PA)............................................................................15
Urology of Indiana (Greenwood, IN)........................................................................................30
Urology Partners (Bradenton, FL)...............................................................................................6
Urologic Specialties of New England (West Warwick, RI)...........................................................8
UroPartners LLC (Chicago, IL).................................................................................................38
Village Podiatry Group (Smyrna, GA).......................................................................................22
Virginia Urology (Richmond, VA).............................................................................................25
Wake Gastroenterology (Raleigh, NC)........................................................................................4
Wayne B. Glazier, MD, Urology (Worcester, MA).......................................................................3
Wilmington Gastroenterology Associates (Wilmington, NC)......................................................7
Total Urologists..............................................................................................................570
Total Gastroenterologists................................................................................................546
Total Other Physicians...................................................................................................265
Total Physicians.............................................................................................................1,381
Total Estimated AP Revenue per Year................................................................$150+ million

 

[KCShaw]

A predicted and expected outcome of existing billing, reimbursement, laboratory, and legal standards. The legality and ethics of self referral are perforated with massive caverns, and apparently so is laboratory supervision. And, of course, if pathologists want anything to change we have to get off of our dougnuts and do something about it beyond whining to each other. Otherwise we have to live in the nursing home others are putting us in.