In ACOs under risk-based models like Medicare Advantage or a commercial shared savings, expenditures are estimated based on patient diagnosis. So if a CKD patient does not have the proper ICD-9 code, the ACO regards this patient as "healthy." Accordingly, they may only estimate expenditures at several hundred dollars per year. But the actual costs may be tens of thousands of dollars more — negatively affecting the ACO's bottom line.
Because of this type of service, we have much closer relationships with providers and patients. So we actually increase our market share with them. All of a sudden, with this service, you increase everyone's loyalty to your lab.
Chief Strategy Officer
Sonic Healthcare