Follow along as we live blog the Mayo Medical Laboratories Leveraging the Laboratory: Advance Your Outreach Conference from Oct. 9-10 in Atlanta, Ga. We will be posting presentation summaries, photos and other multimedia throughout the conference. If you are on Twitter, follow the conference hashtag, which is #2013Leveraging.
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Mayo Medical Laboratories would like to thank all of the attendees and presenters that helped make this year’s conference such a success! We’d also like to thank all of you that took the time to follow along on our live blog. Don’t forget to search #2013Leveraging on Twitter for even more updates from the conference.
Next year’s conference will be held September 24-25 in Rochester, Minn., so be sure to save the date on your calendar!
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“Targeted Therapy for Disconnection: Strengthening the Bond Between Lab Staff and Patients” by Corinne Fantz, Ph.D., of Emory University Hospital
During her presentation, Dr. Fantz described the relationship between disconnection and error, as well as barriers to building patient connections. She also proposed solutions that give urgency to laboratory quality improvement and gave examples of activities used to connect lab staff to patients.
Barriers to building patient connections:
- Culture: Culture eats strategy for breakfast! Trust, transparency and accountability are important!
- Physical Space: Physical space can isolate lab staff from patients, their outcomes, and care providers.
- Have lab staff meet with care providers regularly
- Have lab staff attend patient rounds or visit care areas
- Have lab directors discuss cases with lab staff
- Bring patients into lab to talk about experiences
- Bring patients to lab meetings to solve problems
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“Burn Out & Work/Life Balance” by Ed Creagan, M.D.
In his presentation, Dr. Creagan defined burnout and talked about how to recognize its signs and symptoms.
Unique stressors to laboratorians:
- Internal management v. outside vendors.
- “Future of healthcare” uncertainty.
- Do “more with less.”
- Emotional exhaustion
- Do I make any difference?
- Erosion of empathy
Learn the 3 C’s
Posted at 11:37 a.m. EDT
“Outreach Story” by Mary Jo Metzger of CHRISTUS St. Vincent Regional Medical Center
Ms. Metzger shared the story of CHRISTUS St. Vincent, a not-for-profit, faith-based healthcare system that has been operating in Santa Fe, New Mexico for more than 145 years.
In the mid-1990s, the hospital eliminated its outreach business and formed a reference laboratory with two competitors due to pressure of “capitated rates,” which is a reimbursement approach with lump sum payments. However, the concept did not come to fruition and the hospital lost out on millions of dollars in outpatient revenue.
In 2003, they separated from the reference laboratory and moved to a hospital-based laboratory outreach program that is seeing great success and was built on the following strategies:
- Client Service Manager
- Fee Schedule
- Outpatient Service
- Courier System
- Laboratory Core Operations
- Information Technology (IT)
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“Payer Discussion: Can My Outreach Lab Compete?” by Mike Snyder of Clinical Lab Business Solutions (CLBS)
Reimbursement summary for 2013:
- Pathology reimbursement cut by weighted average of about 14%
- Clinical lab fee schedule cut by 3-5%
- Molecular diagnostic codes cut 20-30%
- Netted out, overall pathology revenue will decrease an estimated 10% in 2013. Previously revenue growth had averaged 7% per year (2007-2012)
Value of networks to health plans:
- No interference to national contracts
- Reduces plan leakage attributable to regional, non-contracted labs
- Decreases the cost of hospital-based testing services
- Introduces utilization management practices across a broad network of participating labs
- Increases member access to preferred in-network services
Critical issues for payer value:
- Meet the payer minimum requirements
- Participate in Ancillary contracts
- Network to increase leverage
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“Sales Through the Eye of the Seller: What Every Manager Needs to Know” by Don Flott
Mr. Flott’s presentation began by identifying macro level disruptions that are impacting the field of laboratory services, as well as disruptions impacting how customers buy.
These disruptions beg the question: do you think you know what your sales person needs to be successful?
What every sales person wishes their boss understood about selling laboratory services:
- I need to know that leaderships supports the effort
- Please understand a car and expense account are tools just like a lab instrument is to testing
- Recognize that selling and trouble-shooting are two different tasks
- I need ongoing training to keep sharp like any other professional
- Sometimes I need our Pathologist or other subject matter experts to make client visits with me
- My credibility with my clients is important so if we say we will do something, we need to pull through
- Occasionally I will run into a brick wall and will need feedback and coaching
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“Lab Design & Remodel on a Budget: Pre and Post Analytic” by Mike Baisch
Mr. Baisch began his presentation by discussing the pre and post analytic activities that occur within the laboratory. He then went on to discuss current state and baseline data collection as well as future state and projections.
Current state data:
- Volume: How much? When does it arrive? TAT expectations
- Timings: How long does it take? Other tasks involved?
Future state conversations:
- Demand – what will happen to my volume
- Mix – what will my volume be made up of
- Any new tasks and are any tasks going away?
- New service level expectations
- Equipment updates or changes
- Floor space constraints or relocation
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“Marketing Lab: Beyond the Brochure” by Lewis Sanderow of OhioHealth
The final presentation of the day came from Lewis Sanderow, Director of Marketing and Communications at OhioHealth. Sanderow outlined the importance of developing a well-researched, thoroughly thought-out marketing plan.
Key aspects of his presentation:
- Marketing plans must be completed as a team. Representatives from key stakeholder groups should be included in the planning process. Potential stakeholders include the marketing director, outreach laboratory director, physicians, pathologists, business development and your reference laboratory partner (such as Mayo Medical Laboratories).
- An effective marketing plan should have the following key sections: Background information, detailed target market descriptions, assessment of the competitive environment, a SWOT analysis, true differentiators, positioning and tone, marketing objectives marketing strategies, marketing tactics, and a budget.
- Business goals (what do you want to do as a business) drive marketing objectives (what you want to accomplish with your marketing efforts), which help you define your marketing strategies (how you plan to use marketing to accomplish your objectives). Finally, tactics help you achieve your marketing strategies.
- Potential tactics that can be utilized to promote laboratory outreach programs include collaborative brochures, location tear pads, a lab practice website (for providers), continuing medical education for local providers, patients brochures, consumer web page (for patients), open house events, signage, an internal newsletter and leveraging system advertising.
- In summary: Having a business plan in place is critical for a successful marketing plan. While many marketing plans are built without them, few are effective without the business goals and strategies well defined.
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“Integration: A Foundation for Outreach Evolution” by Jane Hermansen
Jane Hermansen, MML’s network manager, started off her presentation by defining outreach. While it seems pretty straightforward, the nuances of the definition are critical.
It comes down to the following:
- Not outreach — If there is no choice where the patient’s testing is performed, it is not outreach
- True outreach — Outreach testing comes from “Discretionary Outpatients” such as providers, patients and facilities. Someone made a choice to use your lab over a competing lab. That’s outreach.
Hermansen then outlined an extensive case study illustrating how one health system promoted integration, invested in the laboratory and achieved continuous growth.
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“Economics and Considerations of Outreach” by Tammy Fletcher
Tammy Fletcher, outreach manager for Mayo Medical Laboratories, outlined the importance of properly communicating the financial value of outreach. The key is effective upward communication.
According to Fletcher, the following are key to successful upward communication:
- Know specifically what you want to communicate – Know your goal, your audience’s expectations, your audience’s perspective, and know your information (Inside, outside, upside down).
- Think executive summary – Summarize the data, use charts and graphs, and use plain laboratory language.
- Emphasize benefits to the organization – Make sure you emphasize the fact the laboratory outreach strengthens relationship with physicians in the community, acts as gateway to other services, provides good public relations in the community, and reduces cost per test for inpatient testing.
- Articulate the financial value of outreach:
- Tie finances back to patient care.
- Do not communicate just numbers, but rather an idea.
- Highlight other outreach benefits included integrated medical record, reduction of duplicate testing, broader in-house test menu, and decrease in unit cost associated with a reduction in excess capacity.
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“Maximizing Your Laboratory Outreach: The Path to Success at NGMC” by Jo Brewer of Northeast Georgia Health System
Ms. Brewer’s talk examined the path to success taken by the “HealthLink Lab” of Northeast Georgia Medical Center. Specifically, how lab automation, lean principals and IT can maximize an outreach program and how an effective outreach revenue cycle improves the finances of the lab and hospital.
Tips for success:
- Create separate financial reports for the outreach program
- Focus on customer service
- Have a dedicated sales and service staff
- Create an easy to use web site with an online catalogue
- Make the investment in IT early on
Creating separate financial reports for the outreach program is critically important as it gives the business line needed visibility and helps you understand factors contributing to profitability or lack of.
Creating an outreach financial:
- Identify all direct cost associated with Outreach, i.e. courier, sales staff, specimen processors, registrars, call center staff, outreach IT hardware and software
- Allocate other costs such as labor and supplies by the ratio of outreach tests to total tests
Posted at 10:29 a.m. EDT
“Pathologist’s Role in Specialty Outreach” by Dr. Michael Astion of Seattle Children’s Hospital
Dr. Astion’s presentation discussed the purpose of outreach laboratories, the key decisions in their development and the role of pathologists in outreach laboratories beyond case interpretation.
According to Dr. Astion, reasons for performing outreach include:
- Improve the value of testing to the patient and the organization
- Increased quality and decreased cost
- Enhanced reputation and education
Types of pathologists or doctoral-level staff needed for successful reference laboratory activities:
- Someone who can lead
- A larger group providing case interpretations, troubleshooting errors and difficult cases, and providing good customer service and advice
Key questions laboratories should ask when making decisions about starting and/or improving a reference laboratory practice:
- What will be your relationship to your hospital?
- What type of reference laboratory provider will you be? Will you be a primary provider, secondary provider or both?
- Will pathologists provide test utilization management (UM) services?
- What is your approach to client services (IT, call center, couriers, processing)?
- What is your approach to billing?
- Are you going it alone or partnering with another laboratory?
- Are you taking a revolutionary or evolutionary approach to startup?
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Welcome to our Leveraging the Laboratory Conference
Attendees from 30 states as well as Canada and Indonesia are now in Atlanta for our two-day Leveraging the Laboratory Conference. Twelve speakers will deliver presentations, which discuss the evolving needs of providers, and identify the role of the laboratory, not only as a hidden revenue source, but also as a catalyst for further success.
To kick off the conference and set the stage for the discussions to follow, Course Director John Heywood introduced the following study, first published in 1982
Declining reimbursement will demand innovative delivery methods by M. Mannisto
In summary, hospitals will have to find innovative ways to secure market share as federal reimbursement continues to decline and the commercial insurance industry rebels against the cost shifting burden that is being placed on it. Hospitals can also expect increasing pressure to control costs if inflation rates continue to moderate but hospital expenses exceed the current inflation rates. All in all, the reimbursement system will undergo severe “belt tightening,” which will force hospitals to change their product mix; accept new payment systems, such as capitation; and reduce expenses in order to achieve profitable operating margins.