cycle management software as a stumbling block, 38% lack of software to automate tracking/ analysis of costs, and 37% insuf- ficient staff time.
Jim O’Neill
O’Neill says another roadblock to reimbursements is the inability of labs to collect, from referring physicians, appropriate and com-
plete information required by payers, including medical notes. “Labs must look at their internal systems to make sure their LIS front end system or their middleware company has the appropriate tools to collect the required billing information to get paid from the different payers,” he said. “They should look at in- tegrating data to flow from the LIS or middleware vendor to the billing company with regards to lab reports, requisitions, and doctor and patient chart information/medical notes.”
Coding frustrations and modifications also continue
to challenge lab professionals, with 80% of survey respondents indicating they had taken steps to allevi- ate these issues, including the creation of standard lab processes and staff education materials (78% for non-SARS and 66% for SARS testing) and standard- ized instrumentation workflows and checklists (77% for non-SARS and 57% for SARS testing). Higher deductibles and co-pays mean more lab revenue is coming directly from the patient, and labs struggle financially from patients not paying their bills in a timely manner, according to O’Neill. He says staffing shortages have forced labs to get more creative with how they attempt to collect on these payments, stating: “More labs are sending patient notices via text and email as an alternative to lab billing staff stuff- ing hundreds, if not thousands, of envelopes on a weekly or monthly basis and paying higher postage rates to mail them.”
Uncovering new savings opportunities Those surveyed said they are also finding new sav- ings opportunities to help maximize reimbursements and revenue. The majority (81%) said they have adopted processes to review savings opportunities for non-SARS testing, such as evaluating analyzers on a regular schedule (46% for SARS testing). The implementation of ongoing waste and efficiency studies to find potential savings in overhead is an- other key initiative among lab professionals, with 79% having taken this action for non-SARS testing (43% for SARS). With regards to efforts to improve inventory con- trol and consumable supply costs: • 75% evaluated inventory levels for basic supplies, such as assays and controls/reagents
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• 53% worked with supply chain management on supplies that are on group purchasing organization (GPO) contracts that offer additional savings
• 37% developed supply utilization tracking and record keeping
• 36% worked with other members of the organization, such as the Chief Medical Officer (CMO) and physicians, to standardize test ordering throughout the organization
• 19% implemented vendor-managed ordering • 15% developed ongoing review comparing supply reports to the number of invoiced tests
• 13% gained access to electronic inventory tracking from the supply chain/materials management department
• 10% implemented lease agreements that do not include volume commitments “Labs can’t control consumable supply costs, but they can use nontraditional vendors if they perform the proper vetting,” said Hurst. “We were able to get many needed supplies this way.”
Implementing new tests and technologies When asked what technologies their labs prioritize in their capital budgets, 68% said technology needed to improve quality/reduce costs, 53% technology needed to remain competitive, 48% technology needed to cover staff shortages with automated equipment, and 45% technology needed to cover broken equipment. Hurst said his lab’s implementation of an automation line in December 2019 has helped the team navigate the challenges of the pandemic in terms of high testing volumes and low staffing levels. The lab has long seen the value of automation, having automated its blood bank to be completely paperless back in 2007. The survey findings revealed that close to one-
quarter of labs had automated manual processes in the pre-analytical phase of testing (24%). A similar number had implemented evidence-based test uti- lization backed by data (24%) and/or implemented a pre-approval program for tests that are send-outs (23%). Slightly fewer (17%) had purchased additional centrifuges to reduce bottlenecks in testing workflows. As for best practices around adopting new tools for laboratory automation, such analyzers or software, 63% said they have analyzed workflow processes for proper space planning, 51% involved the IT depart- ment early in the process, and 29% designated a project manager to coordinate short- and long-term planning and implementation with the vendor. With lower revenues and less money to invest in
new technologies, lab leaders must do their best to ensure their equipment upgrades deliver the desired results. Corinne Fantz, PhD, Vice President, Chief Medical Partner, Core Lab and Point of Care, Cardiometabolism and Neurology Network at Roche Diagnostics North America, offers the following recommendations when evaluating analyzers.
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