The community health care delivery landscape is fundamentally and rapidly transforming, and is at a tipping point. Forces of disruptive change include system consolidation, movement toward capitated payment models, profound pricing pressure, and growing demand for evidence from payers combined with an aggressive acquisition of community-based laboratories by commercial laboratories.
Follow along with this blog from Sept. 24-25 to see live updates from the conference. On Twitter? Follow our hashtag: #2014Leveraging.
Sept. 24 | 8:05 a.m.
Ready for Leveraging the Laboratory 2014!
The room is set and the presentations have been saved (finally) and we are ready for our annual Leveraging the Laboratory conference. We are so excited to hear the perspectives and lessons from our amazing guest faculty from around the country; each of them examples of community-based laboratories at their best.
Sept. 24 | 8:35 a.m.
Here We Go!
Leveraging the Laboratory 2014 is officially underway! Course director Don Flott has kicked off our two-day conference with a warm welcome to our attendees. Who's here? We have attendees from three countries and 28 states.
To round out his opening remarks, Flott provided a stark view of the state of health care in the United States and advocated that the laboratory must play a leading role in our transition to Healthcare 2.0.
Sept. 24 | 9:43 a.m.
The first presentation was from Mayo Clinic Administrator Jim Yolch, who discussed in detail our population management activities and plans. The subject of population management is growing in importance each passing day, as health care providers are faced with significant challenges managing patients with chronic disease as more boomers enter into Medicare as well as keeping communities healthy.
Yolch's presentation introduced the key elements of population health management and offer a case study model for community health.
So what is population management? According to Yolch, population management includes an expansion of Patient Centered Medical Home and a redesign of primary care to better address patient needs at population-level across continuum. It is characterized by: patient attribution and registries; standard and consistent practice guidelines; leveraging data (clinical, billing, health plan) to stratify and identify groups of patients with rising medical risk; proactively communicate with patients and coordinate between care team roles; and responsibility for total cost of care and reporting on specific outcomes.
After a primer in population management, Yolch covered a number of key aspects of getting a program off the ground, an overview of the Mayo Model of Care, and several case studies which offered insights to the journey Mayo Clinic has been on in this exciting aspect of health care.
Sept. 24 | 11:13 a.m.
How to Create a Successful Utilization Management Program in the Community Hospital Setting
For those of you that followed our 2014 Utilize Blog, you may recognize this presentation. Utilization is such an essential aspect of the future of laboratory medicine, we asked Dr. Pearson to present it again. His impactful presentation offered attendees clear and actionable examples of how community-based laboratories can implement test utilization strategies and positively impact patient care within their communities.
Sept. 24 | 11:47 a.m.
Focusing on Cost Management
Cost Management. It is a huge issue facing laboratorians and health care organizations at large. To offer perspective, two Mayo Clinic laboratory leaders offered attendees an overview of how Mayo Clinic's clinical laboratories tackled cost management head on. The presenters were:
- Matt Binnicker, Ph.D., Associate Professor of Laboratory Medicine and Pathology, Mayo Clinic
- Ray Frick, Administration, Rochester Operations, Mayo Clinic
Dr. Binnicker outlined the key aspects of implementing a cost management initiative within a laboratory setting. The biggest factor: bringing together a multifaceted approach. Key aspects of the approach include:
- Establish a team to ‘lead the charge’
- Be transparent about expenses
- Define a goal that is both reasonable and attainable
- Solicit ideas from those in the trenches
- Provide regular feedback
- Develop resources/tools to help staff reduce expenses and keep the initiative sustainable
Sept. 24 | 1:44 p.m.
Managing the Gap between Volume and Value-Based Outreach
Health care reform is evolving before our collective eyes. Community-based hospitals and their laboratories are facing a number of huge changes that will forever change how we practice medicine. In his hour-long presentation, Don Flott, Director, Utilization & Integration for Mayo Medical Laboratories, provided a snapshot of where healthcare is going and what "must haves" laboratories need to develop to be successful in Healthcare 2.0.
Key points included:
- Healthcare is changing ... fast: There are major disruptions including rapid health system consolidation, new players to the health care market (e.g., Walmart and other new providers), shifting demographics, and technological advancements.
- Outreach acceleration and network formation is key: A strong outreach program and broad laboratory networks will be the cornerstones of any health system's efforts to meet health care reform and payment models.
- Utilization management is a journey, not a destination: Robust utilization management strategies will be essential to the successful evolution of the role of the laboratory to meet the demands of Healthcare 2.0. These efforts must include the gathering evidence, driving standardization, and reducing variability.
Sept. 24 | 3:04 p.m.
Outreach Service Structure: Manners, Maneuvers, and Measurements
In a light-hearted and fun presentation, our Outreach Support Team offered the three key tenants of an optimal outreach service structure:
- Manners by Shirley Pokorski: Laboratories must dedicate time and resources to defining value and making sure it is quantified. This can be accomplished by forecasting the needs of your customers and appreciating the need to change to ensure you can meet the customer's expectations.
- Maneuvers by Tonya Francis: There are a number of maneuvers laboratories can make to bring value to those who use the laboratory. Francis outlined six maneuvers laboratories should consider: Engage and collaborate; Document evidence of quality; Promote standardization; Consider service level improvements; Incorporate patient-centric solutions; and Apply continuous improvement tactics.
- Measurements by David Pagel: Decide on what metrics you want and what to measure. Most importantly, hold yourself accountable. By adopting firm and practical measurements, laboratories are in a much stronger position to determine monitor the needs of the practice, establish strategic goals, and ultimately ensure customers appreciate the value you bring to them.
Sept. 24 | 4:02 p.m.
Laboratories’ Role in Care and Cost Transformation
To cap of day 1, one of the nation's leading laboratories provided an inside view of how they are leveraging the laboratory's power to help transform health care. The final presenter of the day was Karen Kaul, M.D., Ph.D., the Chair of Pathology and Laboratory Medicine at NorthShore University HealthSystem.
Dr. Kaul mapped out critical steps every laboratory should take as we transition from fee-for-service to value-based reimbursements. According to Dr. Kaul, the laboratory should focus on: reducing waste and unneeded testing; educating colleagues to ensure they are ordering the most appropriate testing; delivering faster and more valuable results; coordinating lab tests across spectrum of care; forcing laboratory staff to be more available to care team; and creating innovative information technology solutions. Dr. Kaul also addressed how investments in information technology enhancements, laboratory automation, and building partnerships throughout the practice can increase value to providers and their patients.
Sept. 25 | 8:49
Ready for Day 2
We are live from Rochester, Minnesota from the Leveraging the Laboratory 2014 Conference. After a brief kick-off presentation by Mayo Medical Laboratory Outreach Manager Tammy Fletcher, the first presentation has just started.
Sept. 25 | 9:12 a.m.
The Patient Experience "From OW to Wow"
The laboratory staff at Campbell County Hospital in Wyoming are doing something amazing. Every parent and phlebotomist knows how pediatric blood draws can be an emotional affair. Lynn Todd, CLS, shared the efforts of the laboratory staff to offer the best experience possible for the children of Campbell County. To accomplish this, the laboratory staff have installed black-lights and painted the walls of each draw room with stunning murals crafted with black-light paint. With the flip of a switch, a typical institutional draw room is transformed into a child's wonderland. The results: Amazed children (with no tears) and relieved parents. Mission accomplished!
Sept. 25 | 11:17 a.m.
Adding Value Through Outreach and EMR Connectivity
The second presentation of the day was from Tania Horton, the Administrative Director of Pathology and Laboratory Medicine at Fletcher Allen Health Care. Horton asserted that a large component of the overall service experience is directly related to IT connectivity. By filling existing gaps left by commercially available physician office connectivity solutions, Fletcher Allen has successfully elevated it service levels. She identified key solutions of success which included the proper utilization of bidirectional interfaces with client hospitals and investing in physician office software interfaces to streamline ordering and resulting.
Horton finished her presentation by outlining a number of challenges that laboratory outreach programs will face in the future. Challenges included, but are not limited to, physician office staffing, technical expertise at client sites, upgrades to EHRs, lines of responsibility (interface or application items), Meaningful Use, and LOINC.
Sept. 25 | 12:12 p.m.
Moving Forward with Billing and Preauthorization
Fletcher Allen Health Care is a leader in laboratory outreach, constantly evolving how it serves its providers and patients. The second Fletcher Allen speaker was Lynn Bryan, Manager of Laboratory Outreach, who provided insights to how her organization was tackling billing and preauthorization challenges.
According to Bryan, laboratory outreach programs and the hospitals they serve are facing incomprehensible changes made to billing and preauthorization requirements by both government and commercial payers. To compound this, many hospital billing systems are simply not capable of the flexibility required to operationalize many of the new requirements.
Over the course of her presentation, Bryan told the story of how her rural academic medical center has evolved to keep up with the rapidly changing healthcare reimbursement landscape.
The bulk of the presentation discussed the four key areas Fletcher Allen focused on to adapt to reimbursement trends. These key areas were obtaining preauthorization from payers, participating in Pre-payment Probes for the Centers for Medicare and Medicaid Services, (CMS), implementing utilization controls to promote inpatient utilization and review of high cost tests, and developing and applying new algorithmic approaches.
Sept. 25 | 1:52 p.m.
The Tale of Two Entities: Co-Branding Your Outreach
"It was the best of times, it was the worst of times ..." That was how Bonnie-Jean Stewart from Hunt Regional Laboratory Solutions framed her laboratory's outreach journey. Taking attendees on an intimate journey, Stewart highlighted her laboratory worst of times and best of times by discussing the issues they faced and game changers they experienced at different times in their history.
The key to Hunt's success: A constant investment in outreach and always pushing the envelope to stay ahead of market trends.
Some highlights included:
- Direct to Consumer Marketing: Offer your community a comprehensive testing menu and allow patients to pay for services directly. Additional aspects of a direct-to-consumer approach are marketing directly to community and employers, printing a coupon in the local newspaper, and attending local health fairs, vendor fairs, and trade shows.
- To-of-Mind Promotional Products: Invest in promotional products and supplies with your organization's branding and contact information. Products need to be functional and useful in day-to-day workflows and activities.
- Marketing: Perform an nongoing market analysis, conduct provider interviews, co-brand to elevate credibility, and leverage reference laboratory outreach resources and expertise, when available.
- Co-Branding: Partner with your reference laboratory on co-branding promotional products such as an electronic catalog, marketing brochures, visiting faculty, posters, newsletters, and algorithms and whitepapers.
Sept. 25 | 2:38 p.m.
Well-Rounded Evaluation of New Product and Service Opportunities
Organizations must continually evaluate their strategic position and direction in the health care market to ensure they remain relevant. In the second to last presentation, Tony Ebert, Business Development Manager at Mayo Medical Laboratories, discussed what laboratories should keep in mind when considering new market demands, first-to-market opportunities, and proposals from outside parties. According to Ebert, each of these opportunities must be examined to determine if they will better position the organization, or, instead, simply use up valuable resources and distract from existing organizational goals.
For the bulk of the presentation, Ebert provided real-world opportunities laboratories might consider and provided tangible feedback on potential legal and business concerns that should be understood. Finally, the vetting process for all new opportunities should include an examination of the various business, operational, strategic, and patient impact factors.
Sept. 25 | 3:38 p.m.
Communicating to the C-Level: Lessons from Our Recent Journey
Leveraging the Laboratory 2014 wrapped up with a presentation by Mayo Medical Laboratories Chief Operating Officer Brian Meade. Meade shared his perspective on how health care reform will effect community-based laboratories, what market trends are influencing the laboratory industry, and what laboratories can do to help their institutions excel.
He finished his presentation with key lessons from his recent experience related to securing approval for an ambitious 5-year plan within an academic medical center. Key lessons range from doing your homework about how the laboratory complements its institution's strategic goals, calculating and proving the financial value of the laboratory, keeping your messages simple when communicating your plan, exercising patience with the process, and maintaining a clear focus on your initial vision and plan.