SC2: Coverage and Reimbursement for Advanced Diagnostics
Room Location: 103
Sunday, March 10 | 2:00-5:00pm
ABOUT THIS COURSE:
Diagnostic testing has advanced at a rapid rate providing physicians and patients with lifesaving information impacting the course of treatment and care. However from advance to simpler diagnostics the industry faces huge difficulties in securing reimbursement as healthcare in the US transforms itself from an activity based fee for service system, to tying provider reimbursement to improved patient outcomes, savings and quality metrics. In addition high deductible plans and increasing cost transparency are forcing consumers to shop around for cost effective care. Successfully establishing clinical utility with stakeholders both locally and nationally will be a foundational topic of the agenda for this workshop.
- Investigating the Background, Implications and Future Outlook of Medicare Reforms to the Clinical Laboratory Fee Schedule
- Development of the value proposition for commercial payers: Key evidence requirements
- Trends in laboratory benefits
- The role of national guidelines in establishing commercial payer coverage
- Know key decision points for optimization of your revenue cycle operations
- Strategically meet industry billing requirements head-on, while minimizing your costs and boosting your bottom-line
Kurt Matthes, Vice President, RCM Reengineering and Service, Revenue Cycle Management, TELCOR Inc
Kurt Matthes currently serves as Vice President of Revenue Cycle Management Reengineering and Service at TELCOR and has more than 25 years of experience in laboratory systems. Mr. Matthes holds a BA in Allied Health from Doane College. Prior to joining TELCOR, Mr. Matthes held a variety of roles in laboratory systems and operations for Bryan Health Systems and Quest Diagnostics.
Becky Foster, Principal, Foster Health Care Consulting
Becky Foster, Principal, has nearly 20 years of industry and consulting experience in managed care, health policy, and reimbursement for biotechnology manufacturers, molecular diagnostic labs, and digital health companies. She has worked across multiple therapeutic areas, drug classes, and treatment modalities for both launch and legacy products. Her experience includes marketing, account management, strategic planning, training, market analytics, and operations. Becky received her undergraduate degree from Harvard and a master’s in public health with a focus on health policy and administration from the University of California at Berkeley.
John Warren, Senior Director, McDermott + Consulting
John Warren is a highly experienced Medicare veteran with wide ranging experience in traditional Medicare fee-for-service, Medicare program integrity, and Medicare contracting issues. With over 22 years of experience inside the Centers for Medicare and Medicaid Services (CMS), John brings a unique perspective to clients of all types and sizes. As the former CMS director of the Divisions responsible for payment policy and program integrity, John is uniquely qualified to speak on matters related to Medicare payment for clinical laboratory services, Part B prescription drugs, and the Medicare physician fee schedule.
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