In a new position statement AACC argues that the success of value-based care will depend on greater collaboration between physicians and laboratory medicine professionals, as well as on renewed commitment from lawmakers and regulators to support evidence-based medicine.
As the Centers for Medicare and Medicaid Services (CMS) and private payers continue to push value-based payment systems, providers face headwinds in returning greater value for fewer dollars due to the sheer complexity of advances in medicine, including laboratory testing. For example, currently there are more than 3,500 laboratory tests for physicians to choose from. “The success of this model depends on the appropriate use of laboratory testing since these tests yield the majority of objective data that help physicians to determine diagnoses and treatment plans,” the association notes. “However, it is unrealistic to expect physicians to be experts in laboratory medicine in addition to their own specialties.”
The position statement cites studies that show nearly 15% of physicians report uncertainty about which tests to order, and nearly 21% of all laboratory tests ordered are either unnecessary or unwarranted based on the patient’s symptoms.
To deal with these challenges, AACC is calling for laboratory medicine professionals to partner with physicians and contribute their specialized knowledge to healthcare teams, such as developing evidence-based test ordering protocols that help physicians select the most effective tests. Already lab professionals are improving utilization in a variety of ways, including disease-specific test ordering guidelines, computerized clinical decision support, and improved educational materials.
AACC also contends that government should do more to enable value-based care through laboratory medicine. The association says CMS should support evidence-based quality measures that assess the utilization of laboratory services and conduct a pilot program that evaluates collaborative models such as diagnostic management teams.
In addition, Congress should continue to fund evidence-based studies through programs such as the Patient-Centered Outcomes Research Institute that evaluate the performance of laboratory tests and provide data for best practice guidelines. The association also endorses additional federal funding for basic and clinical research in the field of laboratory medicine, including the translation of new laboratory tests into clinical practice.