The story line on 2011 is simple: It’s healthcare reform and the continuing call for providers to hold the line on healthcare costs while improving quality. In order to compete in this environment, and to help their customers do the same, Repertoire readers are becoming adept at value-based selling, just as their customers are learning how to implement value-based purchasing. And reps are incorporating technology tools in their daily lives. This week on Repertoire’s blog we’ll take a look at some of the leading stories of 2011 based off of the December issue’s cover story. For the full story and issue visit www.repertoiremag.com. First up, the physician office lab.
The physician office lab
Many experts predicted that physician office labs would fare well because of healthcare reform, with its emphasis on prevention, as well as the growing call for alignment of physicians and hospitals. “Alignment of hospitals and physicians through accountable care organizations provides an opportunity for healthcare providers to examine their disease state care plans and incorporate testing at the most impactful time during a patient’s experience,” said Lisa Wikstrom, vice president of marketing, cardiovascular, Alere Physician Diagnostics Group. (January 2011 Repertoire.)
But clouds were gathering as well over the physician office lab. For example, direct-to-consumer wellness testing offered by such companies as Atlanta, Ga.-based Any Lab Test Now could offer growing competition to the physician office lab. “You’re in and out typically in 15 minutes,” COO Clarissa Bradstock told Repertoire. What’s more, reference labs were expected to continue to lobby for more business from the government and private payers. That’s why distributor sales reps will have to be clearer than ever in their sales message to physicians, said Jonathan Overbey, senior director of sales, Genzyme Diagnostics (now Sekisui Diagnostics). Not only does in-office testing generate revenues for the physician, “it’s better medicine,” he told Repertoire. “It’s best practice. And patients today expect instant turnaround.”
Physician office labs faced another potential threat – increased regulation by the federal government. “As the number of waived laboratories continues to increase and more testing is being performed outside of the moderate/high complexity model, we may see a move by CMS to inspect more waived laboratories, as well as create guidelines that increase oversight by moving waived testing requirements closer to the model that is utilized for mod/high complex testing,” said Doug Beigel, CEO of COLA, an accrediting body for labs. (June 2011 Repertoire.) “We don’t want to add burdens,” a CMS official told Repertoire. At the same time, the agency was examining performance data from waived labs, much of it collected by accrediting organizations, to identify problem areas and propose minimal requirements.
Another question mark for the physician office lab was whether hospital systems that acquire physician practices would attempt to bring tests in to their centralized labs. “Generally speaking, lab testing is addressed during the negotiating process between the hospital and the physician,” said Sumner Spradling, CEO, InfoLab Inc., when asked about which way hospitals and doctors are going on the centralized-vs.-decentralized lab debate. (July 2011 Repertoire.) “So if a physician sees value in the laboratory and wants to retain it as part of the practice, then the hospital is likely to accommodate the doctor during negotiations. But if it gets overlooked or if there is no strong voice, then the hospital is highly likely to assume some or all of the lab testing. We see widely divergent outcomes in this regard, but most acquisitions result in some if not all lab testing migrating to the hospital.”
Mark Zacur, vice president of marketing and business development, Thermo Fisher Scientific, offered this opinion: “In my opinion, it’s easy to integrate the back office, billing, coding, procurement. But as it relates to the lab, I have a hard time envisioning a huge amount of integration. Most of the testing in the physician office is done that way for speed, efficiency and customer loyalty – the ability to get back [with results] to the customer quickly. I don’t know that I see that really changing, at least not for flu, strep, that sort of thing. If more sophisticated testing is required, or there’s some huge financial benefit to leveraging the central lab, I can see that.”