Congress and HCFA have the opportunity to fix the current payment system for clinical laboratory services averting the possibility of a crisis in the future. Payments for some individual tests likely do not reflect the cost of providing services, and anticipated advances in laboratory technology will exacerbate the flaws in the current system. Problems with the outdated payment system could threaten beneficiary access to care and the use of enhanced testing methodologies in the future, although the committee found no evidence of this now. Although radical changes are not called for at this time, implementing the committee’s recommendations will likely improve the efficiency of the system and ensure that Medicare beneficiaries continue to have access to high-quality laboratory services.
Dyckman, Z., and B.B.Cassidy. 2000. Recent Developments and Trends in the Clinical Laboratory Industry (unpublished). Columbia, MD.
Gustafson, T. January 20, 2000. Testimony before the IOM Committee on Medicare Payment Methodology for Clinical Laboratory Services. Washington, DC.
Health Care Financing Administration (HCFA). March 2000 CLIA Provider Files.
Klipp, J. 2000. Lab Industry Strategic Outlook 2000: Market Trends and Analysis. Washington, DC: Washington G-2 Reports.
Merrill Lynch. 1999. Quest Diagnostics: Leader in Sector with Improving Fundamentals. reference #60126501. New York, NY: Merrill Lynch.
Wolf, L.F. 1999. Medicare and Medicaid Statistical Supplement in Health Care Financing Review. Baltimore, MD: Office of Strategic Planning, Health Care Financing Administration.