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Patient-Centric Strategies for Labs: A Roadmap for 2024

by Rachel Muenz | Jan 2, 2024 | Essential, Lab Compliance Advisor, Lab Industry Advisor, Reimbursement-lca

Five strategies for lab leaders to focus on to tackle the challenges of today and ensure future success.

Though lab leaders should have their 2024 business strategies set by now, there are still steps they can take throughout the year to stay focused on their goals, meet challenges, and make the most of opportunities. While labs continue to face hurdles such as denied claims, staffing shortages, and increased costs related to inflation, there are many ways leaders can improve both financial performance and the patient experience by using technology, according to a recent G2 Intelligence Lab Institute Virtual Event presentation.

In the talk, “Thriving in a Difficult Economy: Patient-centric Strategies That Will Improve Your Bottom Line,” John (JD) Donnelly, CEO and founder of FrontRunnerHC, offers five key strategies that remain relevant to lab leaders as they aim for success in 2024. In the presentation, Donnelly suggests that lab leaders pick the strategies they want to focus on addressing in 2024, so that they can overcome both current and future challenges for sustainable success. “The most successful companies are the ones that are very focused,” Donnelly says.¹

Here are the five strategies Donnelly recommends and what lab leaders may want to think about when adapting them for 2024 and beyond:

1. “Turn up the heat”

Patient behavior is a key factor lab leaders will want to take into account when looking to increase collection payments for 2024. With medical debt still an issue and many patients also losing Medicaid coverage, patients may struggle to pay their lab test bills.^2,3 Though a recent White House fact sheet highlights that the number of people in the US “with medical debt on their credit reports” dropped by 8.2 million from early 2020 to early 2022, it remains a significant challenge.⁴ According to the KFF Health Care Debt Survey released in June 2022, 41 percent of US adults have medical or dental-related debt.⁵

Technology can help assess patients’ ability and propensity to pay, enabling lab leaders to make the best decisions for both their organization and their patients. Donnelly shares how heat maps, which are based on patient demographic and financial info plus past payments received by the organization, can be created to “turn up the heat” to improve collections. For example, heat maps can help labs optimize how and when they reach out to clients, or offer payment plans or hardship assistance, saving staff time and energy while improving collection results. Such technologies can also help an organization optimize any necessary collections efforts, and if using collection agencies, focus their efforts on patient claims with low propensity to pay. According to Donnelly, one of FrontRunnerHC’s large genetic lab clients saw a 10 percent increase in collection payments within the first 60 days of leveraging their technology in this area.

Considerations for 2024:

Labs can work with third-party vendors to use a patient-centric collections strategy to help analyze historical patient collections, evaluate and reduce risk, optimize claims management, and maximize future collections with automated programs tailored to each patient’s financial situation. Criteria can be defined to place a lab’s self-pay population into segments, build appropriate business rules for each segment, and automate operational changes like adjustments to dunning cycles to increase future reimbursements, cut costs, and improve the patient’s experience.

2. “Fix it first”

Ensure all patient information is included and correct as soon as possible, ideally when the lab test is ordered. Donnelly encourages labs to “fix it first” to avoid problems later on, such as having to spend time and effort calling physicians or insurers to get the correct information, or claims being delayed or denied. Technology can help labs ensure all the required information is captured and scrubbed upfront, leveraging insurance eligibility and insurance discovery automation. This not only streamlines the process at the front end, but ensures the samples go into the lab with the right patient data, avoiding headaches throughout the lab’s workflow.

Donnelly refers to what he calls a “Super-Clean Order”—one that not only includes accurate patient demographic and insurance information, but also ensures the ordered test complies with medical policy and will be covered by insurance. Such an order also ensures the patient gets the care they need. Given the importance and complexity of lab testing, Donnelly thinks it’s imperative that a Super-Clean Order becomes the norm, not the exception.

Ensuring “clean claims” can also help maintain positive relationships between lab staff and physicians, and between physicians and their patients, as it avoids mistakes, decreases the need to make multiple calls to correct information errors, and minimizes delays. Knowing all the information up front can help labs determine right away whether tests will likely be reimbursed and provide an optimal patient experience.

Considerations for 2024:

With half of claims denials caused by issues at the front end, Donnelly encourages clients to rethink their workflow to catch problems before they start. He shared a stat from one lab expert who said back-end denials can cost a lab 20 to 30 percent in claims and result in affected staff spending up to 60 percent of their time tracking down patient information after the fact. Donnelly encourages avoiding many of these issues with upfront and instant access to accurate patient data.

3. “Power of a point”

Focus on making small, incremental changes to help achieve the lab’s goals and address challenges as, over time, small changes can lead to big benefits. These changes could involve areas such as reimbursement and collections or staffing. Donnelly calls it the “power of a point” and stresses the value of even a one percentage point improvement in key areas. Consistency and discipline are vital. In dealing with staff shortages, for example, lab leaders can look at staff who are performing rote tasks and use technology to automate those tasks, freeing up employees to do more interesting, higher-value work. This allows the lab to not only get more work done, but also retain staff as employees are doing more work they enjoy and aren’t overworked to the point of burning out. Donnelly shares results from a survey done by Lighthouse Lab Services that showed over half of respondents (52%) described themselves as “overworked,” which is not surprising given the reported staffing shortages mentioned in the survey.⁶ According to Donnelly, labor can account for 50 to 70 percent of a lab’s direct costs so focusing on helping staff be more efficient can not only ease staffing challenges, but also lead to significant savings.

Considerations for 2024:

With the squeeze tightening between reimbursements and expenses, identify specific areas where even small improvements would drive value. Look for manual efforts that currently create bottlenecks, exacerbate staffing challenges, or limit key financial metrics like reimbursement and DSO (days sales outstanding). Consider how efforts such as finding and fixing errors in patient insurance information can be accomplished through data automation to cost-effectively improve reimbursements, efficiency, and physician/patient satisfaction. Part of that effort will be to determine a return on investment for any technology spending.

4. “Let sales soar”

Support your sales team so that they can focus on what they are best at—sales—rather than putting out fires. As Donnelly pointed out in his talk, “your organization is only as successful as your sales team.” According to Donnelly, the sales staff of some labs his company has spoken with spend up to two hours a day contacting the provider to find missing patient information or fix inaccurate info for orders to get clean claims out the door. Technology helps to eliminate the wasted time and not only “lets sales soar,” but can also keep the sales team motivated with timely sales commission checks from faster reimbursement. It can also help retain customers; a provider who is disrupted by multiple calls from a lab may decide to take their business elsewhere.

Considerations for 2024:

A shortage of strong sales executives means labs can’t afford to waste any of the sales team’s precious time. Donnelly recently shared that FrontRunnerHC partner Vanguard Healthcare Staffing is seeing some labs try a new sales team model in which they seek to hire associate roles to support their sales executives. These associates may help track down reimbursement issues, identify potential sales targets, or do follow-up communications with prospects, among other tasks. Regardless of role, sales team members can avoid unwelcome calls to physicians and use the newfound time in their day to focus on tasks that will drive additional sales revenue by leveraging automation to find and fix patient info errors and improve reimbursement rates.

5. “Phone a friend”

Think about who is staffing and supporting your lab, and how they can help you find opportunities to grow and address challenges. When considering a vendor or strategic partnership, Donnelly recommended asking five key questions:

- How strong is their network?

- Are they focused on your success?

- What are their capabilities and how strong are those capabilities?

- How innovative, proactive, and collaborative are they?

What is their reputation and does their culture fit with yours?

Considerations for 2024:

“With the technology we have today, you may be regional now, but in 18 months, you could be national,” Donnelly says. “Phone a friend” to leverage the networks of your trusted vendors to support your targeted growth, and understand their position in the industry so you can use it to your lab’s advantage, he adds. He also suggests that labs share their goals with their strategic partners and ask for their support to help achieve them.

Moving forward

Though labs continue to face new and varied challenges, focusing on these patient-centric strategies and using technology can help lab leaders find new opportunities to not just overcome these issues, but achieve sustainable success for their businesses.