Bill Overview
Title: Saving Access to Laboratory Services Act
Description: This bill modifies provisions relating to Medicare payment rates for clinical diagnostic laboratory services, including by requiring payment rates for certain widely available clinical diagnostic laboratory tests to be based on a statistical sampling of private sector rates.
Sponsors: Sen. Burr, Richard [R-NC]
Target Audience
Population: Medicare beneficiaries who rely on clinical diagnostic laboratory services
Estimated Size: 65000000
- The bill impacts clinical diagnostic laboratory services, which are a vital part of healthcare services.
- Medicare is the primary health insurance program in the United States for people aged 65 and older and for some younger people with disabilities.
- Medicare beneficiaries who rely on or will need clinical diagnostic laboratory services will be directly impacted by this bill.
- The global population might include any country looking to the US for precedence in health policy changes, but the direct impact is primarily centered in the US.
Reasoning
- The policy is relevant primarily to older adults who are Medicare beneficiaries, as well as some people with disabilities, as they are the main recipients of Medicare services.
- Clinical diagnostic laboratory services are utilized by a wide range of Medicare beneficiaries including those managing chronic conditions such as diabetes, heart disease, and kidney disorders.
- The policy aims to standardize payment rates, which could impact the availability and affordability of lab tests for beneficiaries.
- The population is quite diverse in terms of health needs, economic status, and geographical distribution, which will impact individual perceptions of the policy's effects.
Simulated Interviews
Retired teacher (Florida)
Age: 75 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- I hope this policy will help lower my lab test costs.
- With my fixed income, it's so important to manage expenses.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 9 | 4 |
| Year 20 | 9 | 4 |
Retired engineer (Texas)
Age: 68 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 8.0 years
Commonness: 8/20
Statement of Opinion:
- If rates are based on the private sector, hopefully, it means more transparency and potentially lower costs.
- These tests are critical for me to keep track of my condition.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
Retired nurse (California)
Age: 82 | Gender: female
Wellbeing Before Policy: 9
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- It might not affect me directly unless my health changes.
- I think it's good for those who need lots of lab work.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 9 | 9 |
| Year 2 | 9 | 8 |
| Year 3 | 9 | 8 |
| Year 5 | 9 | 8 |
| Year 10 | 9 | 7 |
| Year 20 | 9 | 7 |
Disabled, retired early (New York)
Age: 61 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 4/20
Statement of Opinion:
- Affordable lab work is critical to my care.
- I hope this policy can alleviate some of the financial burden.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 8 | 4 |
| Year 10 | 8 | 3 |
| Year 20 | 8 | 3 |
Retired construction worker (Ohio)
Age: 70 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- I think it can make lab work more affordable, which is important for managing my blood pressure.
- It'd be great not to worry so much about costs.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 4 |
Part-time consultant (Pennsylvania)
Age: 65 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 10.0 years
Commonness: 9/20
Statement of Opinion:
- I think it will give me peace of mind knowing costs are standardized.
- I haven't had any major lab tests yet, but it's good to know I'm covered.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 9 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 9 | 7 |
Retired farmer (Illinois)
Age: 77 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 5/20
Statement of Opinion:
- Regular testing is expensive, and every bit of savings helps.
- I hope this policy will reduce the costs substantially.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 7 | 3 |
Retired (Arizona)
Age: 80 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- We share lab expenses, so any reduction is a big relief.
- Standardizing payments is a good move for predictability.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
Semi-retired accountant (Oregon)
Age: 66 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 8/20
Statement of Opinion:
- I think this is a positive step, although I'm still learning about Medicare.
- Costs are always a concern, even if I'm not using the services frequently right now.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Retired librarian (New Jersey)
Age: 71 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- I rely on these tests to keep my heart in check economically.
- I suspect this policy could make a real difference.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 4 |
| Year 20 | 8 | 4 |
Cost Estimates
Year 1: $50000000 (Low: $30000000, High: $70000000)
Year 2: $50000000 (Low: $30000000, High: $70000000)
Year 3: $50000000 (Low: $30000000, High: $70000000)
Year 5: $50000000 (Low: $30000000, High: $70000000)
Year 10: $0 (Low: $0, High: $0)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- Consistency and reliability of private sector rate data for setting payment rates.
- Potential for short-term disruptions in lab test availability during transition.
- Impact on private insurance sectors as they deal with potential ripple effects from Medicare adjustments.