Aetna, UnitedHealth Contracted With Quest and LabCorp

From Health Plan Weekly

Aetna Inc. and UnitedHealth Group recently opened up their lab contracts to let LabCorp. and Quest Diagnostics, respectively, back in their networks — actions that one expert says could indicate a trend.

Those moves suggest that the managed care industry is starting to decide that exclusivity in lab contracting is "not necessarily worth the limitations" that it imposes on members, according to Ashraf Shehata, a principal in KPMG's health care life sciences advisory practice.

"And I think more importantly, it feels like the market might be more interested in trying to see where the competition might take them rather than where exclusivity has taken them," he adds.

This is largely a positive move for insurers, as they could push lab companies to compete based on factors like quality metrics, Shehata suggests. The industry trend of insurers acquiring their own provider networks also offers a potentially competitive opportunity for lab companies to prove they are better at servicing those networks.

Yet one notable potential side effect of insurers moving away from exclusive contracts is the impact it could have on provider-based labs.

When insurers had one exclusive deal with a major lab company, Shehata says, providers could make the case that it's worth paying a little more to reduce abrasion on members and improve care coordination by allowing members to get their lab tests at the same location where they receive care.

"But in this scenario, you can begin to see that value statement is going to be a little more scrutinized," he says.

Subscribers may read the in-depth article online. Learn more about subscribing to AIS Health's publications.