How Medicare's Market-Based Payment System for Laboratory Services Will Change the Industry's Competitive Dynamics In 2019


Instructor: Dennis Weissman
Product ID: 705828
Training Level: Basic to Intermediate

  • Duration: 90 Min
This webinar will discuss how the lab payment cuts imposed by PAMA is shifting the competitive landscape for the U.S. laboratory industry. Specifically, the program will cover how the fallout from PAMA is altering the competitive dynamics between national and hospital outreach labs as well as providing a financial advantage to certain speciality labs offering proprietary tests and other labs performing advanced diagnostic laboratory tests (ADLTs).
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Why Should You Attend:

Prepare your organization now for the changing competitive landscape surrounding the clinical laboratory industry. Understand how the current market reset is directly impacting major lab segments plus find out what they must do to remain viable. Specifically, learn why labs in different practice settings will be forced to assess their strategic options to reorganize, restructure, merge, consolidate or sell altogether. Find out why hospital outreach labs may have to reprice their testing services to remain competitive with independent labs. Learn why Medicare’s market based payment system is having a ripple effect on commercial rates.

Discover why labs offering differing testing services can have either a competitive edge or be at a disadvantage because of Medicare payment policies in today’s volatile market. Finally, gain new insights into what strategies labs will have to consider to remain competitive and how the shifting market dynamics will impact industry consolidation trends.

Areas Covered in the Webinar:

Find out how the Medicare’s market-based payment methodology and resulting payment reductions is fundamentally shifting the laboratory industry’s competitive dynamics

  • Assess how competition between independent & hospital outreach labs is being reset by Medicare payment policies
  • Explain why lab outreach programs must be more transparent in their pricing and competitive in their pricing
  • Discover why lower Medicare pricing will affect lab rates for commercial payers
  • Understand why labs offering proprietary testing have a competitive advantage in today’s market
  • Determine why community and regional labs face the most danger from reduced Medicare rates and what steps they should consider in order to remain in business
  • Reveal how outreach lab programs can retain more advantageous reimbursement from commercial payers
  • Explore why labs should renegotiate future contracts with all outside suppliers including reagent and equipment vendors
  • Identify specific business strategies labs should consider to remain competitive in the volatile lab space
  • Discuss why Medicare payment policies are creating access problems for lab services in rural and inner city areas
  • Learn how the fallout from Medicare rate cuts will affect the future consolidation of the lab industry

Who Will Benefit:

  • Clinical Laboratory founders
  • Presidents
  • CEOs
  • COO
  • CIOs
  • VPs
  • Medical and Administrative Laboratory Directors
  • General Managers and other senior executives including Director of Business Development & Director of Planning
  • Head of Reimbursement
  • Billing and Finance
  • Legal & Compliance Executives
Instructor Profile:
Dennis Weissman

Dennis Weissman
President, Dennis Weissman and Associates LLC

Dennis Weissman is a nationally known, independent analyst, consultant, speaker and thought leader for the clinical laboratory and anatomic pathology sectors for the past three decades. He is President of Dennis Weissman & Associates, LLC, Falls Church, VA, a consultancy which provides market intelligence, business leadership, public policy insights and M&A advisory series to diagnostic and life science companies. Mr. Weissman has expertise is Medicare and healthcare reform policies and trends, laboratory and pathology payment and compliance issues as well as business and financial trends affecting the diagnostic other key health care sectors. He regularly speaks on a wide variety of healthcare topics during webinars, seminars and conferences sponsored by professional associations, medical groups and healthcare companies.

Topic Background:

Starting in 2018, Medicare reimbursement for most high-volume and many other laboratory tests are seeing reductions of up to 10 percent per year from 2018-2020, followed by up to 15 percent for each of the next three years as required by the Protecting Access to Medicare Act (PAMA). All clinical labs in the U.S. — from the largest national reference labs to hospital outreach labs to physician office labs will be impacted by these substantial cuts. Moreover, reduced Medicare payments will also result in lower payments to state Medicaid programs and have a ripple effect to commercial payers which will move to adjust its rates downward as part of future contract terms.

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