Quest Diagnostics 2014 Annual Report Download - page 22

 

 7KHUHPDLQGHURIRXUEDGGHEWH[SHQVHLVSULPDULO\GXHWRPLVVLQJRULQFRUUHFWELOOLQJLQIRUPDWLRQRQUHTXLVLWLRQVDQG
$GYDQFH%HQHILFLDU\1RWLFHVUHFHLYHGIURPKHDOWKFDUHSURYLGHUV,QJHQHUDOGXHWRWKHQDWXUHRIRXUEXVLQHVVKLVWRULFDOO\ZH
KDYHSHUIRUPHGWKHUHTXHVWHGWHVWLQJDQGUHSRUWHGWHVWUHVXOWVUHJDUGOHVVRIZKHWKHUWKHELOOLQJLQIRUPDWLRQLVFRUUHFWRU
FRPSOHWH:HVXEVHTXHQWO\DWWHPSWWRFRQWDFWWKHKHDOWKFDUHSURYLGHURUSDWLHQWWRREWDLQDQ\PLVVLQJLQIRUPDWLRQDQGWR
UHFWLI\LQFRUUHFWELOOLQJLQIRUPDWLRQ0LVVLQJRULQFRUUHFWLQIRUPDWLRQRQUHTXLVLWLRQVFRPSOLFDWHVDQGVORZVGRZQWKHELOOLQJ
SURFHVVFUHDWHVEDFNORJVRIXQELOOHGUHTXLVLWLRQVDQGJHQHUDOO\LQFUHDVHVWKHDJLQJRIDFFRXQWVUHFHLYDEOHDQGEDGGHEW
H[SHQVH7KHLQFUHDVHGXVHRIHOHFWURQLFRUGHULQJUHGXFHVWKHLQFLGHQFHRIPLVVLQJRULQFRUUHFWLQIRUPDWLRQ
Government Coverage and Reimbursements.*RYHUQPHQWSD\HUVVXFKDV0HGLFDUHDQG0HGLFDLGKDYHWDNHQVWHSV
DQGDUHH[SHFWHGWRFRQWLQXHWRWDNHVWHSVWRFRQWUROWKHFRVWXWLOL]DWLRQDQGGHOLYHU\RIKHDOWKFDUHVHUYLFHVLQFOXGLQJFOLQLFDO
WHVWVHUYLFHV)RUH[DPSOH0HGLFDUHKDVDGRSWHGSROLFLHVXQGHUZKLFKLWGRHVQRWSD\IRUPDQ\FRPPRQO\RUGHUHGFOLQLFDO
WHVWVXQOHVVWKHRUGHULQJSK\VLFLDQKDVSURYLGHGDQDSSURSULDWHGLDJQRVLVFRGHVXSSRUWLQJWKHPHGLFDOQHFHVVLW\RIWKHWHVW
3K\VLFLDQVDUHUHTXLUHGE\ODZWRSURYLGHGLDJQRVWLFLQIRUPDWLRQZKHQWKH\RUGHUFOLQLFDOWHVWVIRU0HGLFDUHDQG0HGLFDLG
SDWLHQWV
 :LWKUHJDUGWRWKHFOLQLFDOWHVWLQJVHUYLFHVSHUIRUPHGRQEHKDOIRI0HGLFDUHEHQHILFLDULHVZHPXVWELOOWKH0HGLFDUH
SURJUDPGLUHFWO\DQGPXVWDFFHSWWKHORFDO0HGLFDUHFDUULHUVIHHVFKHGXOHDPRXQWIRUFRYHUHGVHUYLFHVDVSD\PHQWLQIXOO,Q
DGGLWLRQVWDWH0HGLFDLGSURJUDPVDUHSURKLELWHGIURPSD\LQJPRUHDQGLQPRVWLQVWDQFHVSD\VLJQLILFDQWO\OHVVWKDQ
0HGLFDUH&XUUHQWO\0HGLFDUHGRHVQRWUHTXLUHWKHEHQHILFLDU\WRSD\DFRSD\PHQWIRUGLDJQRVWLFLQIRUPDWLRQVHUYLFHV
UHLPEXUVHGXQGHUWKH&OLQLFDO/DERUDWRU\)HH6FKHGXOHEXWJHQHUDOO\GRHVUHTXLUHDSDWLHQWGHGXFWLEOHIRUDQDWRPLFSDWKRORJ\
VHUYLFHV&HUWDLQ0HGLFDLGSURJUDPVUHTXLUH0HGLFDLGUHFLSLHQWVWRSD\FRSD\PHQWDPRXQWVIRUGLDJQRVWLFLQIRUPDWLRQ
VHUYLFHV
 3DUW%RIWKH0HGLFDUHSURJUDPFRQWDLQVIHHVFKHGXOHSD\PHQWPHWKRGRORJLHVIRUFOLQLFDOWHVWLQJVHUYLFHVSHUIRUPHG
IRUFRYHUHGSDWLHQWVLQFOXGLQJDQDWLRQDOFHLOLQJRQWKHDPRXQWWKDWFDUULHUVFRXOGSD\XQGHUWKHLUORFDO0HGLFDUHFOLQLFDO
WHVWLQJIHHVFKHGXOHV+LVWRULFDOO\WKH0HGLFDUH&OLQLFDO/DERUDWRU\)HH6FKHGXOHDQGWKH0HGLFDUH3K\VLFLDQ)HH6FKHGXOH
HVWDEOLVKHGXQGHUWKDWSURJUDPKDYHEHHQVXEMHFWWRFKDQJHLQFOXGLQJHDFK\HDU)RUHDFKVFKHGXOHLVFKDQJLQJDQG
UHLPEXUVHPHQWXQGHUHDFKVFKHGXOHZLOOEHGLIIHUHQWLQWKDQOHYHOV7KHIROORZLQJWDEOHVHWVIRUWKWKHSHUFHQWDJHRI
RXUFRQVROLGDWHGQHWUHYHQXHVUHLPEXUVHGXQGHU0HGLFDUHDWWULEXWDEOHWRWKHFOLQLFDOWHVWLQJDQGSK\VLFLDQIHHVFKHGXOHVLQ

Medicare Part B
Reimbursements
% of our
2014 Consolidated
Net Revenues
&OLQLFDO/DERUDWRU\)HH6FKHGXOH 
3K\VLFLDQ)HH6FKHGXOH 
 3HQDOWLHVIRUYLRODWLRQVRIODZVUHODWLQJWRELOOLQJJRYHUQPHQWKHDOWKFDUHSURJUDPVDQGIRUYLRODWLRQVRIIHGHUDODQG
VWDWHIUDXGDQGDEXVHODZVLQFOXGHH[FOXVLRQIURPSDUWLFLSDWLRQLQ0HGLFDUH0HGLFDLGSURJUDPVDVVHWIRUIHLWXUHV
FLYLODQGFULPLQDOILQHVDQGSHQDOWLHVDQGWKHORVVRIYDULRXVOLFHQVHVFHUWLILFDWHVDQGDXWKRUL]DWLRQVQHFHVVDU\WRRSHUDWH
RXUEXVLQHVV&LYLOPRQHWDU\SHQDOWLHVIRUDZLGHUDQJHRIYLRODWLRQVPD\EHDVVHVVHGRQDSHUYLRODWLRQEDVLV$SDUDOOHOFLYLO
UHPHG\XQGHUWKHIHGHUDO)DOVH&ODLPV$FWSURYLGHVIRUSHQDOWLHVRQDSHUYLRODWLRQEDVLVSOXVGDPDJHVRIXSWRWKUHHWLPHVWKH
DPRXQWFODLPHG
 +LVWRULFDOO\PRVW0HGLFDUHDQG0HGLFDLGEHQHILFLDULHVZHUHFRYHUHGXQGHUWKHWUDGLWLRQDO0HGLFDUHDQG0HGLFDLG
SURJUDPVDGPLQLVWHUHGE\WKHIHGHUDOJRYHUQPHQW5HLPEXUVHPHQWIURPWUDGLWLRQDO0HGLFDUHDQG0HGLFDLGSURJUDPV
UHSUHVHQWHGDSSUR[LPDWHO\RIRXUFRQVROLGDWHGQHWUHYHQXHVGXULQJ2YHUWKHODVWVHYHUDO\HDUVWKHIHGHUDO
JRYHUQPHQWKDVFRQWLQXHGWRH[SDQGLWVFRQWUDFWVZLWKSULYDWHKHDOWKLQVXUDQFHSODQVIRU0HGLFDUHEHQHILFLDULHVDQGKDV
HQFRXUDJHGVXFKEHQHILFLDULHVWRVZLWFKIURPWKHWUDGLWLRQDOSURJUDPVWRWKHSULYDWHSURJUDPVFDOOHG³0HGLFDUH$GYDQWDJH´
SURJUDPV7KHUHKDVEHHQJURZWKRIKHDOWKLQVXUDQFHSURYLGHUVRIIHULQJ0HGLFDUH$GYDQWDJHSURJUDPVDQGRIEHQHILFLDU\
HQUROOPHQWLQWKHVHSURJUDPV,QUHFHQW\HDUVLQDQHIIRUWWRFRQWUROFRVWVVWDWHVDOVRKDYHPDQGDWHGWKDW0HGLFDLG
EHQHILFLDULHVHQUROOLQSULYDWHPDQDJHGFDUHDUUDQJHPHQWV
48(67',$*1267,&6)250
.