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UnitedHealthcare reimbursement cuts have pathology groups on edge "


Full Member
2+ Year Member
Jul 30, 2018
Seems to be a trend. They recent cancelled a bunch of anesthesia and EM contracts. They start with certain states and then quickly jump to more.

They are testing the waters. They are literally daring them to go OON so that they can get slammed by valence billing legislation and be forced to take lower rates.

Pathology just seems to be their most recent foray.
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Med Director New England

Full Member
2+ Year Member
Aug 20, 2018
UNH & atrius health (In my region at least) tends to control outpatient lab costs by going with capitated service agreements with large labs. Paying a fixed amount / life covered for all outpatient studies including AP. In NE they could care less what the 88305 charge is for outpatients it is baked into the lab contract. On the CP side they keep a close eye on blood tests to contain costs & within atrius the PCPs are employed so they are easy to control. I don’t think AP is as closely monitored b/c the real spend is on the CP side.
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