Nine in 10 registered voters are concerned that low Medicare reimbursement rates could threaten patient access to clinical laboratory testing, according to a national survey commissioned by Quest Diagnostics.
The survey found that 88% of respondents would be concerned if Medicare payment rates for laboratory testing were set too low. Meanwhile, 74% said Congress should act to prevent scheduled reimbursement cuts under the Protecting Access to Medicare Act (PAMA).
Support increased to 80% after respondents were told that the reductions could delay access to newer tests for cancer, heart disease, and diabetes.
The findings give clinical laboratories another tool for making the case that reimbursement policy affects more than laboratory finances. Payment reductions also could affect test availability, turnaround times, and patient access, particularly in rural and underserved communities.
“For many dangerous health conditions, laboratory insights are the only tool available to identify disease risks in early, preventable stages,” said Lee H. Hilborne, MD, MPH, senior national medical director at Quest Diagnostics and professor of pathology and laboratory medicine at the University of California, Los Angeles.
Quest and its top competitor, Labcorp, are in an interesting position in terms of PAMA. Publicly, company executives support reducing upcoming PAMA cuts to lab reimbursement rates. However, both companies aggressively acquire struggling community and hospital labs (or their assets). Further PAMA cuts in 2027 would put more financial pressure on these labs.
The online survey was conducted in June among 1,024 self-identified registered voters. Quest also commissioned an oversample of 624 respondents in six cities. The national sample had a margin of error of plus or minus 3.1 percentage points.
Clinical laboratories await permanent PAMA reform
Congress delayed additional reductions to the Medicare Clinical Laboratory Fee Schedule (CLFS) until Jan. 1, 2027. Without further action, reimbursement for approximately 800 laboratory tests could be reduced by as much as 15%.
The bipartisan Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act would revise the process established under the Protecting Access to Medicare Act of 2014 (PAMA).
Supporters argue that the original PAMA methodology relied too heavily on payment data from large independent laboratories and failed to adequately capture higher rates paid to hospital and physician-office laboratories.
The RESULTS Act would provide the Centers for Medicare and Medicaid Services with more representative private payer data, cancel the pending reductions, and eventually limit annual payment cuts to 5%. The legislation has approximately 130 congressional sponsors and support from more than 70 healthcare and patient organizations, Quest stated.
Dark Daily previously reported that clinical laboratory advocates were hoping Congress would vote on the RESULTS Act before the end of 2026.
Quest’s survey indicates that the industry’s argument about patient access may resonate with voters. Half of respondents believed Medicare beneficiaries, rural communities, and patients managing cancer or chronic diseases would all be affected if the reductions take effect.
For clinical laboratory professionals, however, the approaching deadline means continued uncertainty when planning test menus, staffing, equipment investments, and outreach services for 2027.
This article was created with the assistance of Generative AI and has undergone editorial review before publishing.
