Once again, Lab week is upon us. As the second year celebrating Medical Laboratory Professionals Week (MLPW) in the midst of a global pandemic, it’s worth taking a moment to celebrate all our lab professionals and pathologists. Diagnostics is such a vital piece of the healthcare puzzle, and frontline laboratorians have been visible in unprecedented ways throughout the pandemic, but it is still too easy to overlook the countless people behind the scenes who are also part of our robust laboratory network system. Some segments, like molecular, saw volumes ratchet even higher, peaking at more than seven times baseline volumes and causing many labs to make significant investments to meet these higher demands. Currently COVID testing has dropped to about 50% of peak levels, while laboratories’ core business is essentially back to pre-pandemic levels overall. COVID testing is likely to remain a significant factor throughout 2021, albeit at lower levels.
It’s been a year of change. Of gains and losses, ebbs and flows. In that sense, a year like every other, and at the same time, a year like no other. In this past year, laboratories of all specialties have risen to the challenge of bringing testing online for millions of patients.Through supply shortages, burgeoning demand, confusion about test codes and reimbursement, and changing policies, laboratories have never wavered in their dedication.
And it has been a bumpy ride; the XIFIN Laboratory Volume Index recorded fluctuations in testing volumes that peaked at just over 250% overall in mid-January 2021, then fell as COVID testing began to decline as focus shifted away from testing to vaccinations.
While testing volumes give an indication of the wild ride laboratory professionals have been on, it only tells part of the tale. In the midst of all of this, many laboratories moved chunks of their staff to “work from home”, triggering huge cultural, technical, and security challenges. Reimbursement was a constantly evolving hodgepodge of codes, policies, and processes that varied by state and payor. PAMA price adjustments were postponed, giving a temporary reprieve from ongoing price cutting that has plagued the industry for years. At the same time, some insurers moved forward with policies intended to restrict their networks and exert more price control. Denials and prior authorization requirements continued to climb, and the need to be able to efficiently run an appeals program is ever-more critical.
Patients also shifted how they interacted with providers, demanding more information and more transparency, and advancing telehealth by leaps and bounds and recently highlighted in the graph below from the AMA COVID-19 Telehealth Impact Study.1
Patient engagement went from being something of a buzzword in laboratory circles to being a core aspect of the delivery of services.
Delivery of test results became crucial, as was information on costs and coverage. As surprise billing became a family dinner topic, laboratories worked to provide their patients and physicians details on out of pocket costs.
It’s clear that while some things, like routine testing volumes, are beginning to return to “normal,” others are irrevocably changed. Looking ahead, we can see pricing pressures will soon resume in full, and payors will continue to seek ways to narrow their networks. We can see an ongoing need for the laboratory network to stay resilient and nimble, and ready to act when (not if) the next COVID comes along. We know patients will not give up options that afford more convenient access like telehealth, and they will continue to demand more information and control in their healthcare journeys.
And so, as we celebrate lab week and acknowledge the war that has been waged this past year, we can also look down the road and see another year of change, and conflict—and potential. XIFIN is proud to continue to support our customers’ operational needs, and we salute laboratories and the people within them who have worked so tirelessly for so long. Your dedication and perseverance has helped us all on this wild ride. Buckle up, because the ride isn’t over yet!