On April 1, 2014, a new law was signed into effect, entitled the “Protecting Access to Medicare Act of 2014,” or PAMA. This law, which gives Medicare officials the ability to significantly reduce prices of individual tests while requiring labs to gather and report on enormous amounts of market data, has the potential to cause devastating issues for smaller, local laboratories.
As a partner to over 500 leading labs across the globe, hc1.com has outlined two major aspects of this radical legislation, including innovative ways to thrive despite these changes.
- Beginning in 2016, Labs Must Collect and Report on Market Data with Granular Detail (Or Face Significant Penalties)Labs will be required to identify every private payer that paid a claim for each type of lab test, as well as the volume and prices paid by each payer for each type of test. This incredible amount of data will be almost impossible for many smaller labs to collect, mainly because these labs don’t possess the sufficient manpower or time. If labs are unable to collect and report on their data to the CMS, the resulting fines to the clinical labs could be as much as $10,000 a day.Because the hc1.com® Healthcare Relationship Cloud™ is constantly compiling and analyzing critical performance metrics and data, it replaces the manpower and hours that were previously thought to be necessary. With hc1.com Revenue Insight, it is also possible for labs to not only view critical financial metrics, but also collect and access the market data required by PAMA at the click of a button.
- Lab Test Prices May Be Cut By as Much as 75%The CMS plans to reduce prices for 20 high volume tests over six years, based on the lowest price paid by each state’s Medicaid program. These 20 tests represent more than half of what is spent annually on Medicare Part B lab tests, and if the CMS follows through with these price cuts, the resulting financial strain on local clinical labs could be devastating.For labs to survive the oncoming financial strain, labs must embrace new business growth and provide superior client service to ensure client retention. The Healthcare Relationship Cloud™ makes it possible for every staff member to know where to focus, how to proactively handle issues, and when to seize opportunities, resulting in higher retention rates, increased productivity, and stronger sales.
To learn how the hc1.com® Healthcare Relationship Cloud™ can help your lab succeed during the PAMA changes, contact us today!