July 25, 2017
By Brian Castelli, Luminate Health
As Congress debates the future of the Affordable Care Act there is uncertainty around how new legislation will affect the dynamics of the healthcare industry, and uncertainty for patients on how they will continue to access care. Although the future is unclear, most people agree that the transition from fee-for-service to value-based care will continue. In fact, Forbes recently reported that UnitedHealth, Aetna and Anthem “are paying out almost half of their reimbursements via value-based care models”1 Aligning incentives with quality of care and patient outcomes it seems is a bipartisan issue and as a result innovative care delivery methodologies will continue to evolve and establish themselves in the healthcare industry.
The challenge then for medical laboratories is to plan for this inevitable reality by beginning the transition from fee-for-service to value-based care models. In order to do this, and to stay relevant in today’s marketplace, laboratories need to move away from their long-established paradigm of being a transactional, under-valued function to one where they position themselves as health information companies that can add value across the healthcare ecosystem.
Luminate Health had the privilege of once again sponsoring the Executive War College conference in New Orleans this year. One of the major conference themes for 2017 was “Laboratory 2.0″, and how for laboratories to continue to compete in today’s environment they need to provide enriched lab test services that add value for physicians, patients, and payers. Khosrow Shotorbani, CEO of TriCore Reference Laboratories and one of the thought leaders behind Lab 2.0, gave a keynote speech2, where he highlighted the work that he and other members of Project Santa Fe embarked on in the spring of last year. Project Santa Fe is a think-tank style group of laboratory leaders from influential healthcare organizations like Geisinger Health System, Henry Ford Health System, Kaiser Permanente Northern California Health Systems, Northwell Health Laboratories, and TriCore Reference Laboratories. “The coalition was established both to provide thought leadership and to help develop the evidence base for the valuation of clinical laboratory services in the next era of American healthcare.”3
The group has published a white paper on the topic where they highlight the opportunities that laboratories have in transitioning to this new way of thinking and towards value-based care. The group highlights the need for medical laboratories to provide “programmatic leadership in reducing total cost of care through optimization of time-to-diagnosis and time-to-effective therapeutics, optimization of care coordination, and programmatic support of wellness care, screening, and monitoring.”4 We at Luminate Health were excited to see this thought leadership in the industry on display and have been in alignment for quite some time on how the lab of the future needs to utilize its position, and its data, to create value through both pre-diagnostic and post-diagnostic services. It is our view that laboratories can help lead the transition from fee-for-service to value-based care models and leverage the critical diagnostic data that they produce in new and exciting ways.
Luminate Health helps its customers combine patient engagement with health analytics and empowers them to layer value-added services on top of the testing that they perform to enhance the patient experience and close gaps in care. By both engaging the patient and transforming lab data into meaningful analytics, laboratories can make the strategies laid out by the Santa Fe group a reality. For example, Luminate Health works with labs to provide its customers with real-time, patient-centric analytics that target and identify at-risk populations. Once these populations are identified, we use our patient engagement platform to help these patients better manage their health and take clinically meaningful actions, thus bringing the lab’s services to the forefront of patient care. These patient engagement efforts can result in slowing the progression of chronic disease, lowering the overall cost of care and improving outcomes. Laboratories that take advantage of these opportunities to leverage their data and provide value before and after the testing that they perform, will be well positioned to thrive in tomorrow’s healthcare environment, no matter the ultimate fate of the Affordable Care Act.