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Blog Posts by Author: XIFIN

ACLA Wins in Appeals Court Versus HHS

Recently, the DC Court of Appeals determined that federal courts do in fact “have jurisdiction to decide the merits of a challenge to the federal government’s administration of the Protecting Access to Medicare Act (PAMA).”1 This ruling will result in the ACLA vs. Azar case being sent back to the DC District Court to determine if the decision from HHS/CMS to exclude hospital outreach labs from...

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ACLA Issued a Statement to CMS on Automated Chemistry Test Panels

After claims from the Government Accountability Office (GAO) in November of 2018 that labs unbundling automated chemistry test claims will correlate to a drastic increase in Medicare spending, many industry thought leaders are responding. Most recently, ACLA has released a statement claiming that GAO’s assumptions are not backed by Medicare’s public claims data, or by ACLA’s own survey conducted...

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Market Disruption is the New Normal in the Diagnostic Industry

The laboratory and diagnostics industry has experienced tremendous changes in recent years. Top of mind, of course, is PAMA. With cuts totaling up to 30% over the next three years underway, laboratories are operating in one of the most challenging environments seen to date. As had been predicted, labs have had to tighten up their operations to mitigate the lost revenues. Some labs have already...

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The 5 Keys to Minimizing the Impact of PAMA

At this year's Executive War College Conference, XIFIN CEO and Executive Chairman, Lâle White presented on PAMA’s effects on laboratories and gave some thought-provoking ideas on how labs can respond. This blog post will cover many of the topics that Lâle discussed, starting with this timeline of industry events which provides background on the laboratory reimbursement environment...

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Accurate Patient Responsibility Estimates Dramatically Improve the Patient Experience

Customer experience is one of the most significant long-term differentiators in healthcare and diagnostics, as it is in virtually all other sectors. There is a direct correlation between customer experience and engagement, and consumers have been trained to expect more when it comes to service and experience by companies such as Amazon, Apple, and Southwest Airlines. A survey of 1,000 patients...

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Laboratory Economics' Anatomic Pathology & Clinical Lab Survey

Attention pathology groups! Laboratory Economics, an independent market research firm focused on the business of pathology and laboratory medicine, is conducting a survey to gain insight on current business trends among anatomic pathology groups and clinical labs. Please take a few moments to fill out this survey and in return for your participation, you will receive a full summary of the survey...

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Final Steps in Preparing for the PAMA Reporting Period (Part 2)

In our last post of this series, we identified “The First Steps in Preparing for the PAMA Reporting Period” as confirming your laboratory’s applicable lab status, executing an RCM data review, and assigning a project team and project team lead. Once you have carried out these steps, there are four additional steps to be taken before you complete your submission.  Step 4:...

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The First Steps in Preparing for the PAMA Reporting Period (Part 1)

Solid reporting from all applicable laboratories is the key to mitigate future PAMA fee schedule cuts. This means labs need to be able to report on actual allowables vs. payments, validate the accuracy of payments, and optimize appeals activity to avoid under-reporting payments. All applicable labs are included in the current data collection period now underway for the first half of 2019.Step 1:...

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