2019 Program

2019 Program 2019-11-05T13:55:18-08:00

Program subject to change. Please check back for updates.

Wednesday, November 6, 2019

The maturation of machine learning techniques, evolution of massive parallel computer platforms, and ubiquity of data have combined to bring about the Golden Age of Machine Learning. Since the widespread adoption of EMRs, healthcare now also has an abundance of granular clinical data. Applying machine learning to do clinical prediction has advanced significantly in the past few years. Dr. Orr will review the development and validation of several powerful machine learning models to predict high burden disease at earlier, more treatable stages. These models are beginning to play a critical role in care transformation efforts, especially as they relate to risk adjustment, population health, and alternative payment models. We will further review the challenge of getting these predictors into clinical and laboratory workflow, how ML results are messaged to both patients and clinicians, and how clinical outcomes related to these predictors are measured. We will close with a look ahead to how ML models and approaches will improve care delivery for laboratorians and other clinicians, and how ML empowers the transition to value based care.

Presented By: Jeremy Orr, MD, CEO/CMO of Medial Early Sign

As healthcare is transitioning from “sick” care to “well” care and shifting from fee-for-service to value-based models it’s essential that labs develop evidence to demonstrate the new value of the laboratory. The Clinical Lab 2.0 movement is an important catalyst in reengineering the role of the lab in the care continuum to improve patient outcomes, reduce overall cost and align with the future of value-based healthcare.

Panel Moderated By: Beth Bailey, Panelists include Khosrow R. Shotorbani, Lee Hubert & Jeremy Orr.

Labs are ill-equipped to react to the backlog of patient billing, resulting in lost revenue. FrontRunnerHC’s CEO, John Donnelly, will discuss the different factors and trends that are putting labs in bad debt. Based on his extensive experience in the healthcare tech space, he will recommend tools and best practice approaches for labs to get ahead of the problem. Often, a specimen is delivered to labs with a blurb of patient information that may or may not be correct. Labs are responsible for the analysis of these specimens, but now have to take on an additional burden of determining the appropriate parties to be billed for the services rendered. With the incorrect information, the lab runs a risk of billing an incorrect amount to the patient and/or insurer, which creates frustration for both patient and referring physicians. One of the lab giants has reported a loss of $80 million in just their last quarter in 2018 – that would be more than enough to put an independent lab out of business. A trend that will be touched on includes the aggressive increase in patient premium over the past 15 years, and how this shift adds ‘tangle’ to the billing process. This trend, coupled with the fact that only four percent of Americans are well versed with their insurance coverage, puts labs in a hard place to collect on their invoices. The solutions covered will include insurance discovery, propensity to pay gauge, and financial assistance. For preventative solutions, John will walk-through ‘Real-Time Eligibility’ and ‘Prior Authorization’. These are tools that were designed specifically for labs with workflow and are integrated into some of the industries’ most common billing systems.

Presented By: John Donnelly, FrontRunnerHC

Thursday, November 7, 2019

Presented By: Jonathan Ziebarth, Executive Vice President, G2 Intelligence
This session will cover salient topics in laboratory compliance, fraud, and abuse, including:

  • A discussion of recent cases and settlements involving clinical laboratories related to fraud and abuse, and the implications of those cases for other laboratories. Cases to be discussed include the recent $63.5m settlement with Inform Diagnostics (formerly Miraca Life Sciences, Inc.), Boston Heart Diagnostics’ qui tam related to medical necessity of certain tests, pass-through related settlements with commercial payors and several others.
  • The Eliminating Kickbacks and Recovery Act (EKRA), a new all-payor kickback law applying to all laboratory services. What is this law, where did EKRA come from and what do we do now? We will discuss how laboratories are handling the new law, particularly with respect to their marketing employees and contractors and consider what is on the horizon related to this law.
  • Highlights from CMS and the OIG’s proposed changes to the Stark and Anti-kickback regulations, related to value-based arrangements, technology improvements and more relevant to clinical laboratories.
  • Risk mitigation strategies for laboratories.

Presented By: Danielle Sloane, Bass, Berry & Sims

The hospital or health system laboratory is under continual pressure and this is not a new trend. Technology, staffing and regulatory pressures are now considered routine. A larger and more treacherous trend is that laboratory leaders seem to be unable to demonstrate and communicate the true value of their laboratory to administrative leadership. When the laboratory’s value is not recognized or appreciated, they are at risk. The laboratory must be able to look both inward and outward to develop a compelling message that shifts the hospital laboratory from being defensive to being recognized as a proactive and forward-looking asset which delivers sustainable value.

After this session, attendees will be able to:

  • Assess administration’s understanding of the laboratory’s contribution to organizational mission and strategy.
  • Define and align laboratory relevance along three aspects: Clinical, Financial and Operational.
  • Communicate laboratory value beyond historical norms.

Presented By: Jane Hermansen, Mayo Clinic

Laboratory Outreach referral arrangements may involve billing which may implicate several Federal and State laws. With PAMA reimbursement reductions, payor network restrictions, and increased national lab competition pressure, many laboratories may see pass-through of specimens and the associated billing as an advantageous way to increase revenues and gain market share. The health insurers as payors of pass-through lab claim disagree and are focused on stopping this type of potentially fraudulent billing scheme, and have responded with some lawsuits and tougher contracting. Learn what this pass-through billing scheme looks like and how to avoid the pitfalls as well has what a proper Outreach reference lab arrangement might be structured.

Attendees will learn:

  • What hospital outreach pass-through billing is and how to recognize it as a viable strategy vs fraudulent activity.
  • The regulatory implications and compliance concerns associated with pass-through billing.
  • How to structure a proper outreach reference laboratory arrangement.

Presented By: Donna Beasley, Donna Beasley Healthcare Consulting, LLC

Track 1 – Analytics & Data

Deriving Value from Lab Data Using AI

With continued pressure on labs due to fee-for-service margins and the move to value based care, many labs are seeking new ways to derive value from their clinical data. In this session, Prognos will share its experience on where the value of lab data lies and how it can be enhanced using artificial intelligence (AI). The session will cover implications for labs and set the stage to realize additional value from laboratory data.

Attendees will learn:

  • The value of lab data
  • Examples where lab data is of value
  • How AI and machine learning can further unlock value
  • Suggestions for getting started

Presented By: Aron Seidman, Prognos

Track 2 – Lab Management

Are Hospital Outreach Lab Strategies Still Viable?

The overall purpose of the presentation will be to provide insight to today’s market conditions with respect to the viability of hospital laboratory outreach programs, why private health plans are steering patients away from hospital based labs, how PAMA impacted hospital lab services, why executives are reluctant to say yes to strategies to grow outreach, and forecasts for the future of hospital outreach. Has it reached end of life, is it in a down cycle, or is the industry poised for major growth in the next decade?

At the conclusion of this session participants will:

  • Know why private payers are steering patients away from hospital labs
  • Understand why hospital executives are reluctant to pursue hospital outreach growth strategies
  • Have a long term forecast for hospital outreach

Presented By: Jeff Myers, Accumen Inc.

Track 3 – Adding Value to Your Lab

Marketing in a New World: The Impact of EKRA on Your Marketing

EKRA is literally a game changer for the way labs market their tests, and for how the Anti-Kickback Statute is applied to commercial insurance claims. While congress probably intended for EKRA to apply only to labs that obtain referrals from sober homes and treatment facilities, it is drafted to apply to all clinical labs This session will explore the similarities and differences between the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act, identify current and potential regulatory exceptions adopted by the DOJ, analyze the practical impact of EKRA on labs, and explore how labs are responding to EKRA. The session will also take a look at EKRA and ACO arrangements.At the end of the session, attendees will:

  • Understand the Eliminating Kickbacks and Recovery Act
  • Spot arrangements that are impacted by EKRA; and
  • Engage in a Risk Assessment for EKRA compliance

Presented By: Adam Walters, Walters Law PC

Track 1 – Analytics & Data

Artificial Intelligence for the Laboratory: What? When? How?

It used to be a “buzzword” but now artificial intelligence (AI) can provide practical tools for laboratory managers to better understand and manage laboratory operations. Laboratories are repositories of vast amounts of significant clinical and anatomic data. Unfortunately, much of this data is unstructured and difficult to correlate and analyze. AI, by incorporating text analytics and machine learning, allows for a more thorough interrogation of both unstructured and structured data through machine-learned algorithms. AI offers laboratories, as the source of the preponderance of clinical data for a patient, to be a major contributor to improved patient care. When AI tools correlate, analyze and interpret laboratory data in conjunction with radiological, pharmaceutical, physical examination and symptomatic data quicker and better diagnoses and therapies can be prescribed. This presentation will discuss the current “state-of-the art” of artificial intelligence and the potential for its use in laboratories.

After attending the session, participants will be able to:

  • Describe the functions and potentials of artificial intelligence
  • Explain how artificial intelligence may be applied in laboratories
  • Justify further investigation into artificial intelligence, its utilization, its practicality, and prospective sources of AI for your laboratory

Presented By: Larry T Wimberly, Wimberly Consulting Services LLC

Track 2 – Lab Management

Coding & Billing Compliance 2020
  • Discuss procedural and diagnosis coding changes for 2020
  • Describe proposed changes in government reimbursement
  • Discuss pertinent policies and issues affecting coverage
  • As time allows, delve into additional topics of interest or concern

Presented By: Diana Voorhees, DV & Associates

Track 3 – Adding Value to Your Lab

Lab Revenue Strategy, a One, Three and Five Year Outlook

This session will look billing and collections trends, governmental changes, PAMA, EKRA, managed care trends, industry trends, such as BitCoin and Amazon entering the market and the overall tasks that need to be performed to ensure your lab is moving forward in a profitable manner.

After this presentation, attendees will

  • understand the changes taking place in the government, such as PAMA and EKRA
  • learn the basics of a lab revenue strategy
  • know what to implement to be in front of the changes taking place

Presented By: Mick Raich, Vachette Pathology

Track 1 – Analytics & Data

Using Image Analysis in Conjunction with Workflow to Optimize the Benefits of Digital Pathology

This session is an introduction to Image Analysis and Automated workflow for increasing speed and efficiency for the lab. When this is coupled with Digital Pathology, the benefits are compounded for time to diagnosis for the patient and an increase in ROI for the lab.

After attending the session, participants will:

  • Know how image analysis can be used within the laboratory workflow.
  • Gain a deeper knowledge of how automating workflow in specific key areas can increase the speed of a diagnosis for the patient.
  • Be able to bring a solid, computable ROI to their lab management.

Presented By: Lisa-Jean Clifford, Gestalt Diagnostics

Track 2 – Lab Management

The Medicare Appeals Process

This session will address emerging legal issues in the Medicare audit appeal landscape and how it specifically affects Toxicology and Genetic Testing Laboratories. Audit programs, such as the Targeted Probe and Educate (TPE) audit, can have detrimental effects on providers. Given the significant rise in toxicology and genetic testing as well as Medicare and other third-party audits, protecting a laboratory from these audits has never been more relevant. This session will educate attendees on the key audit risk areas and how to reduce this risk, how to respond to TPE audits, as well as how to defend a Medicare Appeal in the case of an audit. Specifically, this session will cover the defenses of waiver of liability and provider without fault, which are particularly applicable to laboratories.

After this presentation, attendees will be able to:

  • Identify and defend against highly targeted audit defense issues affecting laboratories, including genetic, pharmacogenomic, and toxicology testing.
  • Employ strategic approaches and practical tips to consider and implement when appealing overpayment demands and claim denials through the changing Medicare appeals process. Specifically, the presentation will discuss strategic approaches to TPE audits.
  • Develop compliance strategies to reduce audit risk.

Presented By: Andrew Wachler, Wachler & Associates

Track 3 – Adding Value to Your Lab

Laying the Groundwork for Sales Success

Field representation is critical in today’s lab environment in order to win the competitive battle. To be effective, one must understand the different sales methodologies that are required for success. This presentation discusses various aspects of strategy and tactics and other important points that will prepare field reps to be dominate their respective territory. It also discusses the dos and don’ts of designing an optimal sales training program.

After this session, attendees will learn:

  • How to optimize sales performance
  • Different sales technique
  • How to design a sales training program

Presented By: Peter Francis, Clinical Laboratory Sales Training, LLC

Friday, November 8, 2019
FutureLab Friday

Presented By: Jim Pearmain, G2 Intelligence

  • What we will accomplish
  • Rules of the game, Introductions

Presented By: Beth Bailey, TriCore Reference Laboratories

What does FutureLab look like? Where does your lab need focus to be ready to operate in a Clinical Lab 2.0 environment?

Last year’s FutureLab Summit engaged strategic planning experts and lab leaders to connect trends to trajectories and develop a competitive roadmap for your diagnostic lab using Clinical Lab 2.0 ideology. FutureLab 2019 will build on this foundation, updating industry trends and trajectories, then diving into the leadership and cultural competencies critical for navigating in FutureLab, and finally, defining the new value measurements and critical partnerships for FutureLab.

Presented By: Khosrow Shotorbani, Lab 2.0 Strategic Services, LLC

  • Cultural
  • Leadership

Presented By: Beth Bailey, TriCore Reference Laboratories

  • Change the culture, change the game
  • How to create a team charter to promote FutureLab behavior
  • What is important now? And manage to that wisdom

Presented By: Lee Hubert, Voltage Leadership Consulting

In this facilitated work session, participants will examine their lab’s people, technology, and processes to determine strengths and possible gaps in FutureLab.
Participants will use strategic planning tools and Clinical Lab 2.0 ideology to apply the data gathered throughout the session to identify possible strategic actions for FutureLab.

  • SWOT to TOW
  • Action Planning
  • Stakeholder Analysis/Circle of Influence – leadership
Connect With Us...
Linked In Twitter