When doing an in-depth analysis of CF's during this time period, an overall cut of 30% is clearly evident (The Coding Institute, 2011). This dramatic reduction is best summed up by Stan Warner one of the laboratory administrators in Manhattan, "Our lab stands to lose approximately $300,000 for annual billable services if the 30% reduction remains. That's based on a service mix of approximately 20,000 Paps and 15,000 surgical pathology cases a year with 36% of patients Medicare beneficiaries." (The Coding Institute, 2011) This loss of revenue affects all areas of pathology and the clinical laboratory due to the Medicare CFs. Projected decreases of 10.1% in Anatomic Pathology and slight decreases in drug testing despite the overwhelming demand for such tests due to increase in prescription drug abusers. Drug testing had increased by23%, but now the increase is projected to be only 20%. This statistic does not seem too impressive, but clinical laboratories will still lose 3% of reimbursement. With these rate cuts affecting all areas of pathology and the clinical laboratory, it stands to reason that individual tests and test protocols will also be affected.
Test Utilization and Cost Benefit Analysis of Laboratory Tests.
Certain changes in test selection and cost per test analysis are necessary as another method in combating declining reimbursement rates due to ACA and Medicare Part B cuts. It is of utmost importance for laboratory directors to scrutinize all test panels and individual tests performed to determine which of these are ordered infrequently and if the controls, reagents, and consumables for a particular test are cost effective. At this point, a determination can be made as to whether the tests can be removed from the protocol or referred to other testing facilities. In 2010, laboratory tests were selected based on reimbursement claim frequency. This was done by looking at 10 tests per 10,000 Medicare enrollees and only those test that were affected by at least 50% (Asplach, et.
