Understanding the Future Of Laboratory Medicine

Innovators at the leading edge of diagnostics will share successes and lessons learned in April

CEO SUMMARY: Healthcare’s transformation is now far enough along that most clinical labs and pathology groups are either feeling the financial pain or are excitedly developing ways to deliver more value from lab testing services. On April 26-27, at the 21st annual Executive War College on Lab and Pathology Management, expert speakers will address how their labs are responding to the threats and opportunities, while explaining how other labs can duplicate their clinical and financial successes.

MONTH BY MONTH, a cascade of new insights emerges from ongoing research into the various “omes” of humans. Consequently, clinical labs and pathology groups are being handed new tools to use to achieve earlier diagnosis and to contribute to precision medicine.

The pace with which this new knowledge is being adopted in support of clinical care is without precedent. Clinical labs and pathology groups are not the only sectors of healthcare struggling to keep up with these developments. Hospital administrators, physicians, payers, and healthcare policymakers are all overwhelmed by both the speed of change and the sheer volume of new knowledge capable of improving healthcare and delivering better outcomes for patients.

This flood of knowledge is spilling out of research into various “omes” of humans. Take your pick: genome, pro- teome, transcriptome, microbiome, metabolome, epigenome, pharmacogenome. All are producing tens of thousands of new biomarkers that have the potential to be used by clinical labs to diagnose disease earlier and more accurately, to identify effective therapies for individual patients, and to monitor a patient’s progress over time.

Recognizing that the river of clinical knowledge flowing from research into these “omes” is fully disruptive to the world of laboratory medicine as we know it today, this year’s Executive War College on Laboratory and Pathology Medicine, scheduled for April 26-27, 2016, has confirmed experts in all dimensions of the fast-moving fields of molecular diagnostics and genetic testing. These experts will discuss advances in molecular and gene sequencing technologies, how health insurers and the Medicare program are dealing with new lab tests, why labs need more information technology to handle this data, and what innovative clinical labs are already doing to use these new diagnostic insights to deliver more value to physicians, payers, and patients.

Whole human Genomes

There is plenty of news about advances in whole human genome sequencing and that topic will be front-and-center at the Executive War College. Speakers from two of world’s largest efforts to sequence and study large numbers of whole human genomes will provide pathologists and lab managers with an inside look at the early discoveries.

Brad Perkins, MD, is the Chief Medical Officer of Human Longevity, Inc., based in San Diego. This company was founded by C. Craig Venter, PhD, and Peter H. Diamandis, MD, Founder and CEO of the X PRIZE Foundation.

Perkins will discuss how his company has already sequenced 24,000 whole human genomes and is now interpreting that data to identify knowledge that can be introduced into new clinical care pathways in support of both population health management and precision medicine.

UK’s 100,000 Genomes

Following his presentation, Professor Sue Hill, Clinical Lead for the National Health Service in the United Kingdom, will speak. She is involved with the globally-famous 100,000 Genomes Project.

Genomics England, a company wholly owned and funded by the UK’s Department of Health, was established to do the work necessary to sequence 100,000 whole genomes from approximately 70,000 NHS patients by 2017. The participants are NHS patients with a rare disease, plus their families, and patients with cancer.

As clinically-actionable knowledge emerges from the 100,000 Genomes Project, Hill is one of the individuals responsible for developing new clinical pathways and helping to introduce them to physicians in the United Kingdom.

Together, the presentations of Perkins and Hill will give attendees an unprecedented understanding of the current state of the art of whole human genome sequencing—ranging from the cost and operational needs for high volume sequencing to the challenges of collecting the data, storing the data, and interpreting the data to find opportunities for clinical action.

Molecular Diagnostics

Moving from the high-level perspective on genetic medicine to the practical level, in the area of molecular diagnostics and genetic testing, Wayne Grody, MD, PhD, will deliver a session designed to help lab managers in community hospitals understand what new tests are delivering the most value to clinicians.

Grody is Director of the Diagnostic Molecular Pathology Laboratory within the UCLA Medical Center and a Professor in the Departments of Pathology & Laboratory Medicine, Pediatrics, and Human Genetics at the UCLA School of Medicine. In his work, he interacts regularly with community hospitals and thus sees what types of molecular assays and genetic tests are delivering the most clinical value and would be useful for these hospital labs to perform internally.

Additionally, Grody will address the steady flow of new molecular and genetic testing instruments and systems. Not only are these becoming cheaper for hospital labs to purchase, but they feature more automation and accuracy. Their “load and walk-away” features make it feasible for even smaller community hospitals to buy these instruments so as to reduce turn-around time and deliver more value in support of inpatient diagnosis and treatment.

Two topics of interest to every pathologist and lab executive is PAMA lab test price market reporting and the FDA’s guidelines for regulating laboratory-developed tests (LDTs). Those subjects will be front and center during a panel discussion that brings together experts from the American Clinical Laboratory Association,AdvaMedDx,College of American Pathologists, and National Independent Laboratory Association.

Congress, CMS, and FDa

This is the only time and the only place where all these experts come together. They are the individuals tasked by their respective organizations with lobbying Congress on these issues and working with federal regulators to educate them about what labs need to operate efficiently in support of improved patient care.

Thus, they know what is shaping bills in Congress that deal with clinical lab testing and anatomic pathology services. They also participate in meetings with CMS and the FDA on proposed regulations that would govern lab tests. This provides the audience with an insider’s perspective on what is unfolding within the government, why it is happening, and who is supporting or opposing these bills or regulations.

Managed care issues involving billing, coding, audits, network agreements , and coverage for molecular and genetic tests, are also topics of high interest. These topics also represent additional revenue to the lab when the lab team understands how to work with payers to meet changing criteria. A panel of managed care experts will take up these subjects and will include executives from Aetna, Inc., and Blue Cross Blue Shield of Louisiana.

There will be more than 60 sessions and 100 speakers at this year’s Executive War College. The agenda can be found at www.executivewarcollege.com.


Is the End of Private Practice Pathology Here? Experts to Address this Trend on April 28

BIG CHANGES ARE HAPPENING TO MANY PRIVATE PATHOLOGY GROUP PRACTICES. One by one, across the nation, pathology groups are hitting a financial wall that undermines their ability to deliver the quality and breadth of the clinical services they see as necessary to serve their hospitals and client physicians.

But as financially painful as these market trends are, most pathology practice administrators and their pathologist-business leaders still fail to recognize that these are fundamental shifts in the healthcare marketplace. Consequently, these pathology groups often find themselves too far down the road of financial erosion to turn the situation around and restore their pathology practice to solid fiscal solvency.

To address this situation, the organizers of this year’s Executive War College have scheduled a one-day think tank on the fate of private pathology groups. It is titled, “Private Practice Pathology’s Present and Future: What’s Working… What’s Not… with Strategies to Protect and Enhance Pathologist Income.” It will take place on April 28, 2016, in New Orleans.

The workshop is designed to be a must-attend for pathologists who are the business leaders of their groups, along with their practice administrators. Academic pathology groups will also find this to be essential information.

Groups Still Make Money

Successful regional pathology groups, such as Pathology Specialists of Arizona LLP, will discuss their most productive business and clinical strategies. PSA already serves ACOs with large enrollments and is aggressively contracting with managed care plans—particularly the Medicare Advantage plans that have significant market share in Arizona.

An open forum panel discussion will take place that includes attorney Jane Pine Wood, noted legal specialist in pathology and clinical laboratory, Robert Tessier of HBP Services, and an executive from McKesson Revenue Management Solutions, one of the nation’s largest companies providing billing services to anatomic pathology groups and clinical labs. During this session, attendees will interact directly to gain answers and insights into issues specific to their payers, their region, the Medicare program, and more.

Strengthening Finances

For pathology groups considering strategic business options, attorney Rick Cooper of McDonald Hopkins will cover the range of opportunities. Does it make sense to merge with a larger group in the region? What prices are pathology group buyers paying? How should pathologists assess opportunities to sell or transition to employee status?

Two pathology consultants, Tessier and Mick Raich of Vachette Business Services, will share data and advise on specific opportunities to boost the group’s revenue and financial strength. Tessier will demonstrate how public access to Medicare physician price data can help a group negotiate better Part A agreements with hospitals. He will also show the findings of a national pathologist workload study that can help groups balance workload and compensation more effectively.

Raich will speak to how pathology groups can tap overlooked sources of revenue, something he does regularly for his client groups. His topics will include Part A compensation, new managed care opportunities, changes in how to bill payers, and Medicare’s switch from PQRS to MIPS.

Space does not allow full details about Rich Cornell, who will discuss the current pathology job market, or Leigh Polk on how to assess the sales and revenue potential for a pathology group’s service market— then implement a plan to harvest that additional revenue. The full agenda, speakers, and registration details are at www.executivewarcollege.com.

For Labs Needing Revenue: Good Selling Still Pays Off

IT IS POPULAR WISDOM across both the clinical lab and anatomic pathology sectors that sales programs are becoming ineffective ways to build revenue, improve profit margins, and increase the number of client physicians.

That popular wisdom is only partially right. It is correct that a poorly-designed sales program now generates disappointing financial results. It is also correct that hiring average sales reps and then not managing them also produces poor results in today’s tougher financial marketplace.

But what is equally true is that there are clinical labs, specialty testing labs, and anatomic pathology groups that have sales programs that continue to generate profitable new business. What these labs have in common that makes their sales programs financially successful will be taught at the upcoming Executive War College.

The first learning opportunity is the two-hour roundtable discussion conducted by Lab Vice Presidents for Sales and Marketing for Lab Sales VPs, and lab managers responsible for managing their lab’s sales reps.

The second learning opportunity is a full-day workshop, titled “Using Sales Performance Coaching to Boost Revenue and New Clients for Clinical Labs, Pathology Groups, all Specialty and Genetic Testing Labs.” It will be led by Jock Murray, President of the Jock Murray Group, LLC, and will take place on April 28.

Whether experienced at sales management or relatively inexperienced, this workshop teaches coaching as a process of equipping people with the tools, knowledge, and opportunities that they need to develop themselves. This workshop provides sales managers coaching knowledge and strategies, opportunities to practice coaching con- versations, and development of coaching strategies for specific sales team members.



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