2019 Program

2019 Program 2019-07-17T10:23:57-07:00

Program subject to change. Please check back for updates.

Wednesday, November 6, 2019

Presented By: Khosrow R. Shotorbani, MBA MT(ASCP), President, Executive Director, Project Santa Fe Foundation, Founder, CEO-Lab 2.0 Strategic Services

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, Founder of Vachette

The diagnostic reimbursement terrain is in state of constant motion: Mergers, acquisitions, strategic alliances and exclusivity continue to leave all laboratories guessing where they stand. Barriers to entry seem to shift often while the process for seeking coverage for newer technologies often appears to lack any formulaic transparency, from one payer to the next.

We will review all the relevant headlines, changes and the perceived impact: both near term and downstream, where diagnostic labs are concerned. We’ll also share case studies demonstrating where our clients have adapted, adjusted and been proactive in terms of both protecting and fostering their payer relationships. We’ll discuss where the reimbursement market may be heading and provide some resources and introduce intermediaries that could offer some solutions and relief.

Three takeaways:

  • Understand how recent changes in the payer space impact my laboratory and how to adapt.
  • Hear about some case studies of successful access and payer coverage.
  • Learn about third-party resources, vehicles and potential entry points for Payer engagement.

Presented By: Andrew Stimmler, Managing Partner, Shipwright Healthcare Group

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: Dennis Winsten, MS, FHIMSS, FCLMA

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 B. Wachler, Esq., Partner, Wachler & Associates, P.C.

Thursday, November 7, 2019

On Oct. 24, 2018, President Trump signed the SUPPORT Act into law. Hidden in the Act was a new law which attempted to apply the Anti-Kickback Statute to commercial insurance claims with regards to sober homes, treatment centers, and laboratories. While congress probably intended for this law to apply to clinical laboratories that obtain referrals from sober homes and treatment facilities, it is drafted to apply to all clinical laboratories and is a game changer for the way laboratories market their test.

This presentation will: (i) address, in detail, the similarities and differences between the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act; (ii) discuss current and potential regulatory exceptions adopted by the Department of Justice; (iii) discuss the practical effect on the laboratory industry and how laboratories are responding. The presentation will also address, on a higher level, the interplay between EKRA and Accountable Care Organization 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 M. Walters, Principal, Walters Law PC

In this session, Lee Hubert will look at the common change management errors and explain how to create a workplace environment that is conducive to change.

At the conclusion of this session participants will be able to:

  • Identify gain a greater understanding of why most change efforts fail
  • Understand how to Go 1:1 to build support for new initiatives
  • Utilize asset-based thinking to avoid the Iceberg of Ignorance

Presented By: Lee Hubert, Principal Consultant, Voltage Leadership Consulting / Founder iTrainManagersforSuccess

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 techniques and
  • How to design a sales training program

Presented By: Peter Francis, President, Clinical laboratory Sales Training, LLC

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, Manager, Outreach and Network Development, Mayo Clinic Laboratory Medicine and Pathology

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, CPA, Vice President of Consulting, Accumen

Analyte to Algorithm to Action to Impact

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, MPH, CMO, Medial EarlySign

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, VP, Product Management, Prognos

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