Lab Market Update

Strategies to Offset Medicare Cuts to Be Shared at Exec. War College

Other sessions will focus on getting paid for more lab test claims, test utilization, and adding value

DEEP PRICE CUTS to the Medicare Part B Clinical Laboratory Fee Schedule was the big story of 2017. The big story of 2018 may be the widespread financial disruption to the clinical lab industry as labs see dramatic declines in their revenue from these Medicare fee cuts.

One early opportunity for lab administrators and pathologists to understand the full scope of these Medicare price cuts will happen in New Orleans on May 1-2. That’s when the 23rd annual Executive War College on Lab and Pathology Management will bring together 100 speakers in more than 60 sessions.

Front and center at the Executive War College will be two aspects of the Medicare fee cuts. First will be reports from major lab organizations and the nation’s largest lab billing and collection companies as to the precise declines in lab revenue they are tracking. This will be the first opportunity for the lab managers to assess the cumulative impact that Medicare price cuts have had nationally during the four months since they became effective.

Negative Financial Effect

Second will be sessions led by labs and lab billing companies to share which strategies are proving most effective at offsetting the negative financial impact of the Medicare fee cuts. This is essential knowledge that every lab can use, since the need to reduce costs by enough to offset the lost revenue from the Medicare price cuts is essential for labs to stay financially viable.

Other equally significant issues will be addressed this year. For example, multiple sessions will deal with effective ways to get paid for lab test claims. Contracting with insurers to win network status and the most effective ways to successfully appeal denied claims will be discussed. Other sessions will focus on responding to tougher payer audits.

Prior-Authorization Programs

Another major issue is the expanded use of prior-authorization programs by major insurers and the growing influence of laboratory benefit management companies. These subjects will be covered in several sessions and will be of particular interest to labs that perform molecular and genetic tests.

The positive opportunities for clinical labs and pathology groups to grow, improve profitability, and deliver more value will be discussed by multiple speakers. One aspect of this is how labs add value by working with physicians to improve the utilization of lab tests. There are exciting breakthroughs in this aspect of clinical laboratory operations.

Because space is limited, it is recommended that lab executives register early. Confirmed sessions and speakers are posted at www.executivewarcollege.com.

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