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Mmmm Medicare Money….

Student Perspective: Clinical Political Science continued

e-LABorate

The first day we were there we were informed about the current position laboratorians were in.  Important subjects such as competitive bidding, licensure, and work shortages were brought up.  We learned a lot about Medicare, and the politics surrounding it.  The politics, to me, sounded more confusing the more I learned. 

To speak in terms I understand, Medicare money is like a big pie that doesn't change size very often, but the slices are cut up differently from time to time.  Politicians try to satisfy all the cravings for the different contributors to a Medicare patients care (doctors, nurses, radiology, housekeeping etc...) by allocating a slice of the Medicare money pie to them.  Naturally, people are concerned about their slice; in the case of the laboratorians, our slice can be made more efficient by restructuring the Medicare pay schedule which hasn't been modified in years.  Competitive bidding's goal is to create more realistic prices, seeing how the cost of doing a basic metabolic panel has changed in the last 10 years for example.  On one hand competitive bidding will force a pay schedule change, which is needed; on the other hand, the repercussions on small labs and billing departments across the country may be potentially devastating to patient care.

Mmmm Medicare Money….

The CLMA, or Clinical Laboratory Management Association, has devised a strategy to prevent competitive bidding, and offer a solution.  This solution is known as the Clinical Laboratory Fee Schedule Modernization Act of 2008, quite a mouthful I must say.  In short, this act is meant to modernize the cost of laboratory fees to reflect the current times (as opposed to those set up in 1984).  The act will utilize a committee of organizations which represent the large and small independent labs, hospitals, physicians, non-physicians, manufacturers and other political arms connected to Medicare.  The goal of this is much like Competitive Bidding, with fewer headaches, to modernize the cost of laboratory tests and restructure the piece of Medicare pie laboratories get.

Moving away from competitive bidding, laboratory personnel shortage is an issue many labs have had to cope with and this problem is not going away.  One incredible fact I learned was that the average age of a lab employee is nearly 49.2 years old.  This fact alone can make you wonder "What’s going to happen when these experienced lab professionals retire?”  Furthermore, it has been projected that by 2016 the U.S. will need 92,000 more laboratory professionals to provide proper patient care.  Currently, an average of 4,700 lab professionals graduates per year.  You can do the math; it doesn't look good.  Hard-to-get funding, education cuts, and entire programs falling to the wayside are a few of the reasons this personnel shortage is occurring.  

Our job on "the Hill" was to bring these issues up to our representatives.  Laboratorians from around the country met with there representatives' health aids to bring these issues up and provide solutions to help our cause.  It was great experience bringing up real issues to try to make a real difference.  In addition, throughout my day on "the Hill" it wasn't unusual to come across fellow laboratorians going to their specific representative's office to do the same.   It was an uplifting feeling to see that we were all trying to make a difference.  We will see in the coming year how competitive bidding, personnel shortage and other issues are addressed.  One thing that I certainly learned is that these issues will take time and a lot of effort to be completed.  What we did in Washington D.C. is something that all laboratory professionals can do to help the cause.  It sounds difficult and intimidating, but scheduling time to meet with your representatives to bring up theses issues is not an unreasonable task.  Lastly, a little goes a long way; the more help we can get addressing these issues the more likely we can succeed.