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3 Ways COVID-19 Will Impact Q4 Testing

As COVID continues to challenge the laboratory industry, XIFIN executives expect a 15% increase in COVID-19 volumes in the fall and regional labs to pick up overflow from larger, national players.

This news was announced at a recent conference called “COVID-19’s Impact on Lab Industry Testing Volumes and Dynamics – September Update,” where XIFIN CEO Lâle White, XIFIN Executive Vice President & General Manager of Diagnostic Services Kyle Fetter, and UBS analysts highlighted critical factors expected to impact Q4 COVID-19 testing.

“Six months into the COVID-19 pandemic, diagnostic labs nationwide continue to see high testing volumes. Early implementation of rapid diagnostics testing could positively impact overall testing volumes and data collection for the remainder of 2020 and into 2021, but we’re not there yet,” said White. “Labs are making a significant effort to manage large quantities of both clinical and administrative data, from testing results to patient insurance information, claims, and reimbursement — it’s a tall order. So-called ‘clean orders’ are a huge focus and critical measurement for labs in terms of profitability and the patient experience. XIFIN is committed to providing labs — so critical to the pandemic effort – with the ability to better manage their data and optimize both workflow and revenues.”

Highlights from the conference include:

Fall Testing Volumes Expected to Rise

Analyzing data from its extensive Lab Volume Index, a weekly reporting of nationwide lab testing volume, XIFIN said that data shows a rise in COVID-19 testing in early September. This uptick is a seemingly direct correlation to back-to-school activity and the start of the cold and flu season.

Testing increases are expected into the winter months, as XIFIN predicts up to a 15% increase in COVID-19 testing volumes from the August low point. An increase in the use of a combination flu and COVID-19 PCR test is also likely. Overall, the industry has returned to approximately 95% of its baseline volume (pre-COVID) for routine testing, and the hospital segment’s routine testing exceeded its baseline volumes, according to the XIFIN Lab Volume Index.

Regional Labs Alleviate High Testing Levels and Reporting Demands

Frequently changing Centers for Disease Control and Prevention (CDC) reporting criteria make it difficult for labs to continually update their systems to report the CDC’s requested data. This results in reporting delays and other challenges when labs are under pressure to manage testing demands across diagnostic sectors.

XIFIN said regional labs, which have a smaller staff and fewer resources than larger labs, are conducting testing up to three times their average volumes. Regional labs secure more local employer and provider COVID-19 testing contracts. In contrast, the major testing contracts for situations, such as student body testing at higher ed institutions, are often captured by the larger labs.

Payors Respond to Government Guidance Yet Underpayment Continues

XIFIN reported that payor reimbursement rates improved in the last 90 days, with 17% of claims for COVID-19 antibody and PCR testing being paid below Medicare rates. This was an improvement compared to the early phases of the pandemic when payors were improperly denying or mis-paying 43% of these claims. It’s also evidence of the success of XIFIN’s payor relations’ and its customers’ outreach to educate payors on proper rates and reimbursement rules. XIFIN reports, however, that a number of private and public payors are improperly denying or underpaying claims, causing financial strain to labs. 

COVID-19’s effects on the lab industry show the importance of maintaining a nationwide sound and healthy diagnostic industry and how that might influence future reimbursement rates. Through the CARES Act, clinical labs have a one-year reprieve from the reporting requirements outlined under the Protecting Access to Medicare Act (PAMA) and a one-year delay of rate cuts initially planned for next year. Recent lobbying efforts have shed light on the severe impact of PAMA on labs and the Act’s negative impact on reimbursement rates — indicating that the government now has some understanding of the adverse effects on diagnostic labs of both past and future PAMA cuts.

Listen to the full UBS Audio conference for more insights COVID's impact on diagnostic volumes, mix, reimbursement, and more.

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Published by XIFIN
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