Laboratory news leader ADVANCE, which shares thought leadership content around lab science, chemistry, and other fields, recently published their January 2017 eBook. This comprehensive journey offers more than 25 pages of tips, trends, and educational content for healthcare leaders and innovators. Brad Bostic, CEO of hc1.com, authored a featured article in this month’s edition of ADVANCE, entitled “3 Ways to Survive PAMA”.
PAMA, the all-encompassing healthcare regulation, has already begun transforming the way laboratories and healthcare providers collect and leverage live data. The new regulations require any lab with more than $12,500 in Medicare revenues and more than 50% of overall revenue from Medicare to submit all private payor claims data to CMS. This data will then be used by CMS to revise the new cycles of Medicare and Medicaid payment rates. The biggest thing standing in the way for lab survival? These new payment rates.
“PAMA is expected to save CMS upwards of $5.14 billion over the next 10 years,” writes Bostic in the article. This is $5.14 billion that will no longer be paid out to laboratories via reimbursements – $5.14 billion that the laboratory must figure out how to recapture to survive. Today’s labs must take proactive steps to increase revenue and optimize internal efficiency to overcome this daunting loss of reimbursements. Here are the steps Bostic outlines in the ADVANCE article:
Maximize And Retain Revenue
Maximizing revenue comes down to streamlining collaboration and communication between a lab’s internal departments and external stakeholders. This means understanding high-value tests and ordering physicians and understanding ordering trends. Retaining current clients should continue to be a top priority for any lab looking towards success. This means visualizing client relationships in real-time to pinpoint account health and ordering status.
Monitor Lab Performance in Real Time
Even without the strenuous demands of PAMA, laboratories should be dedicated to improving overall performance and increase internal efficiencies. Monitoring and understanding lab performance in real time gives lab decision makers the insight needed to proactively address issues or critical events before they spiral out of control.
Capture New Revenue
Laboratories with a clean, steady stream of new and returning business are best positioned to survive the effects of PAMA regulations. Field representatives, managers, and executives should all have visibility into sales pipeline, ongoing activities, and overarching analytics. Insight into current opportunities, existing business, and up-sell activities can help maximize incoming revenue across the board.
It is only through effective planning, execution, and reliance on innovative technologies that laboratories can survive the hard-hitting effects of PAMA.