AMP report recommends improvements to PHE clinical testing economics

April 27, 2022

The Association for Molecular Pathology (AMP), a global, molecular diagnostic professional society, released a report entitled “Economics of Clinical Testing during a Public Health Emergency (PHE): Lessons Learned from Two Years of COVID-19;” the detailed assessment reflects on the first two years of the COVID-19 pandemic, dissects various coding, coverage, and pricing policies, and provides 15 recommendations to help prevent or at least mitigate these same economic challenges in the future, according to a news release.

An effective pandemic response requires laboratories, manufacturers, policymakers, and insurers to be nimble and adapt to a quickly changing landscape. Clinical laboratories were hampered by uncertain or ineffective action to address economic issues when diagnostic testing was one of the few health measures available to inform behavior and mitigate the impact of the novel coronavirus. Policy measures lacked appropriate input, or generally failed to provide the assurance of economic stability needed for laboratories to support their role in protecting Americans’ health during the public health emergency. To help ensure that reactionary policies do not have unintended and negative consequences, the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) need to engage laboratory stakeholders early and across the spectrum of care delivery environments before laboratory policies are implemented.

“Over the last two years, clinical laboratories across the country have been on the frontlines of the pandemic, doing their best to keep up with a relentless and wildly unpredictable demand for molecular diagnostic testing.  Operational strains to meet the needs of the public have been compounded by financial uncertainties arising from challenges in the systems for coding, pricing, and coverage,” said Samuel K. Caughron, MD, AMP Economic Affairs Committee Chair and President and CEO of MAWD Pathology Group. “AMP decided to develop this report to share key lessons learned and offer strategic recommendations to improve our nation’s awareness and ability to respond to future public health emergencies to protect the wellbeing of all our patients.”

Throughout the COVID-19 pandemic, AMP has worked to meet its members’ education, clinical practice, and advocacy needs. This latest economic assessment will be crucial in providing a detailed retrospective analysis to inform future discussions with payers, federal agencies, and members of Congress.

AMP will continue to actively work with many professional organizations as part of its ongoing commitment to informing and influencing public policies that ensure fair and reasonable reimbursement for qualified healthcare professionals providing high-quality molecular diagnostic services.

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