As we head into the remaining months of 2023 and begin finalizing plans and strategies for the new year, it is a great time to acknowledge the invaluable contribution that laboratories make to our nation’s healthcare. It is with that lens that Orchard Software continues to advocate for and support our laboratory partners.

Over the past several years, the industry has dealt with Protecting Access to Medicare Act (PAMA) cuts and the threat of future cuts. We support the Saving Access to Laboratory Services Act (SALSA), which is intended to improve PAMA’s data reporting requirements and payment methodology to reduce the negative impact on laboratories. At the same time, we continue to build on and develop new Information Technology (IT) efficiency gains to help laboratories deal with reimbursement cuts and staff shortages.

The Reimbursement Situation

During the first set of Medicare reimbursement cuts under PAMA, many commonly performed tests were reduced by 30%. Across three years of cuts, Clinical Laboratory Fee Schedule (CLFS) payments were reduced by nearly $4 billion.¹ 

In March of 2023, SALSA was reintroduced to address PAMA’s data reporting requirements and CLFS payment cuts. SALSA will require broader data collection across the full laboratory market and will limit annual payment reductions. SALSA also protects against drastic rate cuts, reduces the administrative burden on laboratories, and increases time between reporting periods.

How Your Lab Can Prepare

Clinical laboratories are actively advocating for SALSA using the Stop Lab Cuts campaign. The website allows you to easily contact your congressional representatives to let them know that you support SALSA and are concerned about the long-term effect of CLFS cuts. The campaign intends to ensure patient access to laboratory testing and protect the laboratory infrastructure. We encourage you to get involved and add your voice!

Internally, laboratories must also continue to focus on processes and performance improvements to gain efficiency and improve revenue capture, including the use of IT and automation tools to streamline processes and reduce errors.

How Orchard Helps

At Orchard Software, we have your concerns top of mind and are continually pushing to drive efficiency within our solution offerings. For example, recently we completed WASPLab® integration for more efficient microbiology workflow. Orchard® Enterprise Lab™ integrates with WASPLab to automate orders, set up tasks, report negative observations, and send preliminary or final reports.

To streamline testing, Orchard® Molecular™ supports dynamic, configurable workflows; allows for “on-the-fly” workflow deviations; and provides decision support for rules and ask-at-order entry questions. It also has a configurable sample, patient, and order hierarchy to help you better organize and automate your workflow management.

We are adding tools to support insurance verification to further streamline laboratory accessioning and billing. Our upcoming insurance verification feature improves billing efficiency by integrating with insurance verification vendors. This integration eliminates the manual process of insurance verification and allows responses from vendors to automatically update the patient record and ensure accuracy prior to billing. The incidence of rejected claims is greatly reduced, and revenue cycle turnaround and the overall billing process is improved.

We have also added new tools to provide greater access and visibility to our support services through our client portal. The new, improved customer portal allows you to track your support cases and interact with the technician assigned to your case. You can enter feature requests and access eLearning. The portal improves communication and offers an easy path to numerous valuable resources like online help articles, training materials, release notes, and newsletters.

Looking to 2024

In 2024, our continued focus will be on our customers, partnering with you to succeed in managing changes within the industry and facing challenges together. We will continue to develop our solutions based on client feedback to drive efficiency and support proper reimbursements.

Reference

1. American Clinical Laboratory Association. ACLA and 25 provider organizations urge Congress to protect access to critical laboratory tests for seniors and all patients. https://www.acla.com/acla-and-26-provider-organizations-urge-congress-to-protect-access-to-critical-laboratory-tests-for-seniors-and-all-patients. Published September 2022.