While not reported in our informal poll, interviews with PHL directors revealed that state PHLs, North Dakota and Oregon, have worked specifically to open communication lines with MCOs and private laboratories to avoid duplicative efforts in laboratory services. In North Dakota, the state PHL director negotiated an arrangement with Blue Cross of North Dakota whereby Blue Cross would no longer pay for HIV, TB, and prenatal hepatitis testing, since the state PHL was already funded by the state to perform these tests.
In return, Blue Cross notified its providers to send these specimens to the state PHL, and the health department benefited from obtaining more specimens for disease surveillance purposes.
In Oregon, a state which did not report formal collaboration/contracting, the PHL works with private laboratories to ensure continuity of testing for tuberculosis. The PHL has the state's largest tuberculosis testing capacity. Under this arrangement, private laboratories generally culture the sputum sample and isolate an organism that might be suspected as TB, then send the sample to the state PHL, which performs genetic probing and confirmation testing for TB. The state also performs antibiotic resistance testing for TB. Since the state laboratory gets state funding for this type of TB testing, both the public and private parties benefit under this arrangement.