Vol 6   Issue 5

October 2002

Update on the Regional Laboratory Alliance and Health Plan Contracting Strategies

The Regional Laboratory Alliance (RLA) of Kansas City continues to aggressively work with health plans in the Kansas City region to ensure your ability to send tests to the laboratory of choice for your patients is not hindered.  It is our goal to open access to the RLA laboratories for all patients.   

Many questions and concerns from our physician colleagues and hospital leaders have surfaced with the recent news of the merger between Mid-America Health and Coventry.  Thus far, there have been no changes to the networks and the RLA will continue to provide services without interruption to your patients.  

In order to assist the RLA in their efforts to build relationships with Coventry, Blue Cross Blue Shield, Aetna and other payors in our region, we are encouraging physicians to strongly voice their position regarding laboratory services.  To assist you and your colleagues in this effort the following talking points have been developed to contrast the differences between commercial laboratories and the laboratories of the RLA.

· Healthcare Focus:  The Regional Laboratory Alliance is made up of 9 area hospital laboratories (Saint Luke’s Hospital of Kansas City, Saint Luke’s Northland Hospital, Shawnee Mission Medical Center, Saint Joseph Health Center, Children’s Mercy Hospitals and Clinics, St. Mary’s Hospital of Blue Springs, Liberty Hospital, Providence Medical Center, and Saint John Hospital), one locally pathologist-owned reference laboratory (Physicians Reference Laboratory) and Mayo Medical Laboratory in Rochester, Minnesota, all focused on medically relevant direct patient care for the Kansas City region.

Commercial laboratories are publicly traded, stockholder-owned corporations with operational and clinical infra-structures that are usually remote and distanced from the local health care delivery system. 

· Comprehensive and Local:  The RLA provides full clinical, anatomic pathology and cytology services locally for over 2000 physicians, 37 hospitals and 12 ambulatory surgery centers in the Kansas City area.  This creates for full integration of laboratory records and prevents fragmentation of the care continuum. 

Commercial laboratories typically perform, refer and transport specimens for clinical, anatomic pathology and cytology testing across numerous locations throughout the United States.   

· Pediatric Expertise:  The RLA members have extensive expertise in drawing all pediatric patients and utilize age specific specimen requirements. 

Commercial labs may not draw pediatric specimens on children under the age of 7 months and specimen requirements for pediatric patients older than 7 months may not be age adjusted.

· Draw Sites and Hours of Operation:   RLA laboratories are physician/patient focused with 23 local drawing stations located in and around the Kansas City region and STAT testing capabilities 24 hours a day, 7 days a week, 365 days a year.

Commercial laboratories normally do not perform STAT testing, do not provide 24/7 coverage, and access is limited to the hours of operation posted at their drawing stations.

· Test Menu:  More than 99% of the lab tests referred to the RLA are performed by the local RLA laboratories. 

Commercial laboratory test menus are limited, necessitating a high rate of referrals to outside labs, impacting turnaround time and specimen and result integrity.  . 

· Pathology Consultation:  The RLA pathologists consult with clinicians daily on patient care matters and in the development of clinical pathways and test protocols. 

· Continuity of Care:  The RLA provides a consistent source of high quality laboratory testing services across all sites of care (inpatient, outpatient, physician office), which supports continuity of care, results integrity and support for clinician decision making.

Thank you for your past and future support of the RLA.  If you have any concerns or would like additional information regarding the RLA services, please contact Carla Brewer, the RLA General Manager, by phone at 800-580-7114 or by email at brewer.Carla@mayo.edu