Pathology gap fees

Consumers can face large gap payments for pathology, but a public provider may be able to provide a gap-free alternative.
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04.Case Study

Professor Ruth Salom is executive director of SA Pathology, a government-owned enterprise that provides pathology services to all South Australian public hospitals and to the public through “IMVS”-branded outlets. Income is derived from Medicare in the form of the bulk bill rebate for community pathology, and the public hospitals also pay SA Pathology for work at the Medicare rebate rate.

SA Pathology receives no money from state general revenue for provision of pathology services. The company is expected to provide high-quality 24-hour service to hospitals and doctors across the whole state, maintain a full complement of trained staff and provide a surplus to fund medical research within SA Pathology at the Centre of Cancer Biology. Direct funding of research amounts to about $9 million from a turnover of about $250 million. This model for a public enterprise is not without risk, given the significant reliance on private work. SA Pathology does about 40% of all private pathology in SA.


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