Sanford is throwing a fairly wide loop. Moira Larsen, it strikes me that everyone ought to get a good atlas of the United States to be a winner long term in the lab pathology business.
Moira Larsen, MD, MBA, physician executive director, MedStar Medical Group Pathology, MedStar Health, Columbia, Md.: Absolutely. I was struck by Sterling Bennett’s comments—you need to sell your services. You need not think of outreach as a global process but instead to identify specific service lines, whether it’s AP or specialty lab testing, where you offer something that makes a profit. By having a relationship with leadership, you can bring that to them and let it be the start of something bigger, because once they see that laboratory is not a cost center but can bring revenue, you begin to get a response. That’s why I’m building an external anatomic pathology laboratory.
I have found that by talking with people and explaining our services, our turnaround times, our expertise, and the ability to talk to a pathologist about a case and not spend hours on hold with a customer service line—that level of customer service will often tip the scale and help you grow in ways that allow you to continue to show and increase your value and thus stave off that search for the outside, quick answer that some systems appear to go for.
At the CAP, there’s emphasis on what pathologists themselves need to do from an attitudinal and even a skills perspective to flourish in the new environment. Dr. Sharma, can you comment on that?
Dr. Sharma (Henry Ford): I was part of the CAP advocacy training program and went to Washington. The Wayne County Medical Society recently organized a daylong conference, at which I was able to spend time with Senator Elissa Slotkin of Michigan. While we were getting ready for her speech in the green room, there was a conversation about why health care is important. The Affordable Care Act had a lot of changes, and many people who are impacted by those changes may not even know it. The senator’s concern was that many Michiganders’ premiums went up, or the out-of-pocket limit went up and coverage went down, and those bills will start coming now.
We are already thinking about reducing reimbursement but also looking at a possibility in which many people may forgo preventive service because it is partially or less covered or no longer covered.
I am hearing increasing anecdotal discussion of patients going to see physicians, getting lab orders, and then not getting drawn for the lab test. People get busy and it can be a hassle to get drawn, but I also think there’s growing concern about the copays for those tests. Dr. Sossaman, do you see that in your area in Utah?
Dr. Sossaman (Intermountain): Not as much, but I’ve heard a similar concern from others in different areas. It has to do with how patients get billed for hospital outpatient services—for example, a copay in addition to a hospital-based facility fee. That can influence patients’ decisions on whether they should get lab draws, particularly if they’re having to go to a Coumadin clinic or have a chronic disease that requires frequent testing. It impacts people’s willingness to go in.
Clark Day, a final comment from you?
Clark Day (IU Health): I agree with what others have said. Connectivity to executive leadership is key, and once you deliver on something successful, that builds credibility and more support and trust to invest in you. The laboratory’s story and that connectivity need to be about the patient-oriented value the laboratory’s services bring. Even patient experience. The lab at IU Health is 10 percent of our health system’s patient experience score weight. So you don’t have to put together a big financial presentation—at least we haven’t had to—to justify how much you’re worth. It’s about that patient benefit the laboratory provides.