A few PHLs in our informal poll reported positive impacts from the growth of managed care. According to our informal poll results of PHL directors, among the positive impacts identified by PHL directors were increased collaboration between the PHL and the state health agency, and an increase in specialized types of reference testing by the PHL.
In Virginia, the recognition of managed care and the pressure to be cost conscious have prompted the state PHL to strengthen its partnership with the state health agency, particularly the Office of Epidemiology. In Kentucky, the state PHL has begun its strategic planning process for the laboratory, which coincides with the Kentucky Department of Health's overall strategy development initiatives in response to increased managed care presence.
Another example of collaboration, due in part to the growth of MCOs, is the Washington State Clinical Laboratory Advisory Committee (CLAC). With membership from both the public and private sectors, this program has assumed a proactive leadership role in shaping the laboratory delivery system in Washington state. Results from this program (described in more detail below) include improved communication, consensus on reimbursement issues, and pilot programs in the area of clinical guidelines.