HEALTH CARE REFORM

Value-Based Care: AACC Cites Key Role of Lab Professionals in Making It Work

Laboratory professionals have a central role to play in supporting the transition to value-based care, according to a new American Academy of Clinical Chemistry (AACC) position statement.

Lab Expertise Crucial to Success of Value-Based Care
The AACC notes that clinical laboratorians have expertise that can better inform test utilization and test interpretation, which can benefit the health care system through improved patient outcomes and reduced costs under value-based care.

Unlike inpatient care, which is reimbursed under a single diagnosis-related group (DRG) code, outpatient testing is still primarily reimbursed under fee-for-service models. New payment models — including accountable care organizations and bundled care arrangements — still rely on lab results, but require greater care coordination and cost control. Since lab data informs the majority of clinical decision-making, lab professionals can help ensure it is used most efficiently and effectively.

"Laboratory medicine professionals are poised to contribute their expertise to work with clinicians in devising more effective and efficient diagnostic and therapeutic protocols, and should be invited to be part of guideline development panels," notes the AACC position statement.

AACC’s Recommendations for Lab Pros
To enhance test utilization, AACC recommends that lab professionals assist in expanding clinician education, developing disease-specific test ordering guidelines and creating computerized clinical decision support interventions that identify tests not suitable for certain conditions being investigated.

To improve test interpretation, AACC calls for greater interaction among laboratorians and medical practitioners. AACC also suggests that lab professionals can include interpretative comments to enhance test reports when results cannot be understood by the numeric data alone or when the finding is unique. There should be diagnostic management teams that include a clinical laboratory representative to collaboratively interpret the results in conjunction with the clinical symptoms, says the AACC.

The AACC also calls for continued funding of studies at the federal agency level to develop evidence-based testing guidelines, evaluate translational research of the value of new laboratory tests, and assess how wider adoption of collaborative caregiver group models impacts patient outcomes and costs.

Takeaway: AACC urges laboratory professionals to play an active role in demonstrating the value of laboratory medicine during this period of transition to value-based health care delivery.

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