Drug Screens and Insurance as Subsidy

Several months ago I started a quest for a new laboratory for oral fluid drug screens to conduct in my office, and got a lesson in medical economics in the bargain.

Oral fluid offers advantages over urine, particularly since we can observe collection with the patient in the waiting room. Also, since we mail the specimen to the laboratory for analysis, we do not have to worry about CLIA compliance.

I had hoped I could use Labcorp, which integrates with my electronic medical record, reporting results electronically, so I started with Labcorp. I connected with my representative there with some difficulty, but at first she evaded questions about pricing, assuring me that insurance would pay for the testing anyway. Eventually I discovered the analysis would cost more than $50, at least 4 times higher than what I had expected. The next few laps I contacted provided similar responses.

I had liked using the Quantisal collection device in the past, so I contacted them directly. They provided a list of laboratories using their technology, and I contacted each. Eventually I found several labs with much better pricing (under $10) and no run around. I chose J2 Laboratories whose service allows me to test for 6 drugs including buprenorphine, and I feel like my cash patients will get good value for their precious money.

Not that I like medical insurance companies, but with attitudes toward reimbursement examplified by Labcorp no wonder they push so hard to control costs. Let's hope Obamacare will bring improvements.

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