Preventive Screenings and Routine Testing Are Essential for Protecting Seniors’ Health
With Medicare reimbursement for nearly 600 laboratory tests scheduled for significant cuts in a matter of weeks, 56 million seniors are at risk of losing access to vital lab tests and diagnostics that help them stay healthy and manage existing conditions. The culprit? The poorly implemented 2014 Protecting Access to Medicare Act (PAMA).
Though PAMA was meant to establish a uniform reimbursement system for lab tests and services under Medicare, the U.S. Department of Health and Human Services’ (HHS) misguided implementation of the law has led to 3 years of draconian cuts to the tests Americans rely on. By drastically cutting rates, including for many of the most commonly performed lab tests, PAMA may threaten access to critical lab services for diagnosing and treating beneficiaries with diabetes, heart disease, liver disease, kidney disease, prostate and colon cancers, anemia, infections, opioid dependency and countless other common health conditions.
This comes at a time where many of America’s seniors are already struggling to access these essential laboratory services due to the COVID-19 pandemic. According to recent public health studies, roughly 1 in 5 Medicare beneficiaries avoided or missed necessary medical care last year as a result of the pandemic. Of those, more than one-third (32%) skipped vital laboratory testing and diagnostics, which are critical to early detection and prevention of serious diseases.
As the foundation for early diagnosis, prevention and personalized care for millions of patients, the value of clinical laboratories remains unmatched. Protecting access to these vital laboratory services should remain a top priority. Even more, a dedicated focus on both prevention and early detection can drive savings across the health system by helping to identify diseases and risk factors for diseases at an early stage. Undiagnosed diabetes alone, for example, is associated with $31.7 billion in annual spending that could have been avoided through earlier diagnosis and better disease management.
In order to continue providing value to patients, we must first protect access to quality care, including high quality clinical laboratory services. As the COVID-19 pandemic has proved, we must continue to advocate for widespread access to laboratory services for the early detection and prevention of other serious diseases that disproportionately impact seniors and vulnerable populations.
We shouldn’t make it harder for seniors to stay healthy – Congress needs to protect seniors’ access to laboratory tests and diagnostic services. Congress has already recognized this threat and delayed PAMA cuts and a second round of flawed PAMA data reporting for one-year in Section 3718 the bipartisan Coronavirus Aid, Relief, and Economic Security Act in 2020. Congress needs to act immediately and delay the cuts and data reporting for clinical labs another year.
