WASHINGTON — In response to ongoing Medicare reimbursement changes that aim to enhance patient care while reducing healthcare costs, AACC released a position statement today emphasizing that clinical laboratory tests must be used effectively for this new payment system to achieve its objectives. The statement advocates for increased collaboration between physicians and laboratory medicine professionals, who have the expertise to ensure that the right test is ordered for each patient and that results are interpreted correctly.
In recent years, the Centers for Medicare and Medicaid Services (CMS) has been transitioning to a payment model that rewards providers for more efficient, evidence-based care instead of simply reimbursing them for volume of services. The success of this model depends on the appropriate use of laboratory testing since these tests yield the majority of objective data that help physicians to determine diagnoses and treatment plans. However, it is unrealistic to expect physicians to be experts in laboratory medicine in addition to their own specialties. More than 3,500 laboratory tests are available—a list that is constantly evolving with advances in research and technology. As a result of this complexity, one study found that physicians are unsure of how to interpret test results in an estimated 13 million patients per year, and nearly 15% of physicians report uncertainty about what tests to order. Studies also indicate that hospitals could potentially cut costs by $5 billion annually by eliminating redundant tests—a goal that laboratory medicine experts could help reach.
To improve patient care and lower healthcare spending through better test utilization, AACC encourages laboratory medicine professionals to partner with physicians and contribute their specialized knowledge to the healthcare team. Laboratory professionals and physicians should work together to develop evidence-based test ordering protocols designed to help physicians select the most effective tests for patients. Because physicians receive limited formal education in laboratory medicine, laboratory organizations and physician societies should team to develop laboratory courses for inclusion in medical school curricula. At the federal agency level, AACC also recommends that CMS conduct a pilot program to evaluate how wider adoption of new, more inclusive collaborative caregiver group models would impact patient outcomes and costs.
“The changing Medicare payment paradigm creates new opportunities for health systems to advance patient care while more efficiently and effectively utilizing their resources,” said AACC CEO Janet B. Kreizman. “Laboratory medicine experts are uniquely positioned to ensure this is achieved by working with physicians to devise optimal diagnostic and therapeutic protocols, leading to better health outcomes and reduced costs.
Dedicated to achieving better health through laboratory medicine, AACC brings together more than 50,000 clinical laboratory professionals, physicians, research scientists, and business leaders from around the world focused on clinical chemistry, molecular diagnostics, mass spectrometry, translational medicine, lab management, and other areas of progressing laboratory science. Since 1948, AACC has worked to advance the common interests of the field, providing programs that advance scientific collaboration, knowledge, expertise, and innovation in support of improved health outcomes for patients. For more information, visit www.aacc.org.