Managing opportunities under managed care.

Health care reform is driving significant changes in associations between physicians, hospitals, insurers, and patients. This restructuring of the delivery of care will affect the practice of pathology. At these crossroads, practices have to decide to continue without change or to adopt new approaches. Horizontal mergers between pathology practices offer one opportunity under health care reform. Such mergers reflect the general trend toward consolidation of operations as a cost-effective approach to health care delivery. They will require a reevaluation of the manpower needs in pathology. The move to consolidated health plans also suggests that pathology practices should consider vertical integration with other physicians. Restructuring of practices is not the sole answer to addressing health care reform. Practices must become involved in cost-saving strategies in the systems.