MANY OF US POINT OUT THAT LABORATORY MEDICINE is an undervalued and under-utilized asset within the American healthcare system. Lab testing is generally a minimal cost relative to the total episode of care, yet lab testing provides essential knowledge to help clinicians make a quick, accurate diagnosis and confidently select appropriate therapies.
Like the late comedian Rodney Dangerfield, many lab directors and pathologists feel like “I don’t get no respect!”, particularly when negotiating contracts with managed care plans. Seldom is the true value of laboratory testing acknowledged by payers, particularly in the form of adequate reimbursement.
However, this situation may be on the verge of changing. In this issue of THE DARK REPORT, we provide intelligence briefings on two important home runs hit by laboratories during the past 24 months. First up is our coverage about the explosion in vitamin D testing. Labs across the country are reporting that vitamin D test volumes have doubled and tripled over the most recent
12 months! ARUP Laboratories tells us that about one-third of the vitamin D test results indicate that the individual is vitamin D-deficient. This fact is evidence that physicians are using the test appropriately. (See pages 3-5.)
That remarkable lab testing home run is followed by the story of another, even more amazing lab testing home run. At Washington Hospital Center (WHC) in Washington, DC, a rapid PNA FISH test for bloodstream infections, combined with real-time results reporting to the attending physician, has contributed to an 83% drop in patient mortality in ICU settings—and a 53% overall reduction in patient mortality related to bloodstream infections! (See pages 6-9.)
The unique twist to the WHC experience is that these dramatic reductions in patient mortality only came after the procedure for reporting the PNA FISH tests was changed to incorporate a personal phone call to the attending physician, to ensure he/she got the results in real time.
Now comes the next challenge for the lab industry. Will Medicare and private payers recognize this value provided by labs to their referring clinicians? Will Medicare and private payers establish reasonable reimbursement for these testing services? Too often in the past, payers publicly promote the importance of patients getting these tests, while, in private, they excoriate labs for not controlling test utilization and financially penalize them for the higher volume of testing that was performed