Patient Access to Lab Services

Coinsurance would disrupt the ability of health care practitioners to work with their patients to ascertain the best lab tests to help best diagnose new conditions, manage existing conditions, and guide therapy, which is critical for the Medicare population as they often have multiple comorbidities. Currently, since there is no cost-sharing, patients who need more lab tests due to more complicated health conditions have no greater financial risk than patients those with less complex conditions when receiving their lab results – and a patient may not know whether their condition is simple or complex when they first see a doctor. Despite this common-sense approach, some policy-makers calling for entitlement reform and deficit reduction have proposed putting into place a new 20% patient coinsurance for clinical laboratory services as an attempt to make Medicare beneficiaries more aware of health care costs. In real life, coinsurance for lab services will dis-incentivize Medicare beneficiaries from receiving timely and life-saving clinical lab tests, thus increasing health care costs through worse outcomes, and would drastically increase the cost of providing lab services through generating millions of new patient bills.