By Kelly A. Briganti, Editorial Director, G2 Intelligence
Throughout two and a half days on Capitol Hill, laboratory insiders debated and shared knowledge, insight and concerns about compliance issues, new business challenges and the latest regulatory changes affecting the diagnostic industry, during G2 Intelligence’s 33rd Annual Lab Institute (Oct. 14-16). The opening Keynote address from Steven Brill, author of America’s Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken health care System, helped set the tone of the conference discussing the rising cost of the American health care system and how the Affordable Care Act is both changing the industry yet failing to bring enough change. Following Brill, Quest Diagnostics Chief Executive Officer Steve Rusckowski referred to the laboratory industry as America’s “Sweet Pill” and emphasized laboratories’ influence on 70% of medical decisions for relatively low cost, exhorting the industry to take advantage of the opportunity to be a “part of the transformation of healthcare.”
Speakers repeatedly echoed Rusckowski’s sentiment, noting the laboratory’s ability to connect people with the information needed to make health care decisions and the need to demonstrate the value of this information. An overwhelming concern throughout the conference was how laboratories will be paid for their services. The Centers for Medicare & Medicaid’s recently proposed rule implementing the Protecting Access to Medicare Act (PAMA) served as the focal point of a heated panel discussion that addressed the impact of proposed changes to how the clinical laboratory fee schedule is determined. The proposed rule requires specifically defined Applicable Laboratories prepare to report by March 31, 2016, private payer reimbursement data for the period July 1, 2015 through Dec. 31, 2015. Debate centered on whether the interests of all stakeholders in the industry have been adequately considered, with particular concern raised about the exclusion of hospital laboratory payment rates from the proposed data collection and the impact of the resulting Medicare rates on smaller and independent laboratories. PeaceHealth Laboratories Chief Executive Ran Whitehead described his experiences meeting with Capitol Hill members to educate them on the realities that laboratories are facing and indicated the need for others to similarly inform their representatives. Panelists and attendees throughout the conference reiterated a consistent message: the laboratory industry needs to work together to demonstrate their value and make their voices heard by their legislators as well as other health care organizations, payers, potential partners, and patients.