LBMs Are Coming on Strong, Says HAffairs Blog Post

But can lab benefit managers avoid the kind of criticism that PBMs have come under?

In Health Affairs blog post today, Kathyrn Phillips and Patricia Deverka describe the rise of the laboratory benefit managers (LBMs) and compare and contrast them to PBMs. 

LBMs came on the scene in the 2000s, they say, often as part of larger companies that have carved out other areas of medical care for specialized management and cost control, such as radiology. LBMs and PBMs both use tools like network suppliers and coverage policies. Phillips and Deverka quote company-provided claims about reducing "lab spend" and reducing patient out-of-pocket costs but also mention that they couldn't find published evidence about the effect LBMs have on clinical management and patient outcomes.

Their list of five major LBMs consists of AIM Specialty Health, owned by Anthem; Avalon Healthcare Solutions, which is privately owned; Beacon Lab Benefit Solutions, owned by LabCorp; eviCore, owned by Cigna; and Kentmere Lab Benefit Management Program, which is privately owned.

Charles Cini of Kentmere wrote a Viewpoint article for Managed Care last year. You can read it here

PBMs have come under attack and investigation lately as intermediaries that use rebates, spread pricing, and other tactics to pull in profits from the drug supply chain. Phillips and Deverka say that LBMs could avoid becoming the target of criticism with "proactive development of transparent, objective evidence on their processes and outcomes." 

"It will be important," they continue, "to continue to track the clinical and financial evolution of LBMs to determine whether there is evidence that they are having a deleterious impact on costs and outcomes for patients."