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New AMP Survey Reports Insufficient Reimbursement for Analysis, Interpretation of MDx Test Results

NEW YORK – The Association for Molecular Pathology on Tuesday released a new survey that found reimbursement for the work surrounding molecular diagnostic testing, such as interpretation, is lacking. 

The "Analysis of Professional Work Effort in Molecular Test Interpretation Report" polled more than 100 professionals from AMP and the American College of Medical Genetics and Genomics, both physicians and qualified doctoral scientists, who said that adequate reimbursement for data analysis, test interpretation, and reporting requirements would improve patient care by "increasing access to these essential medical services and enabling more data-driven treatment decisions," AMP said in a statement. 

"As molecular diagnostic procedures become increasingly complex, and both the value and need for testing continue to grow, so does demand for the services of qualified molecular laboratory professionals," Samuel Caughron, AMP's Economic Affairs Committee chair, said in a statement. "The vital services these professionals provide need to be accounted for and reimbursed."

According to the survey, analysis, interpretation, and reporting can take more than six hours per test, but the time, expertise, and effort of doing so are not accounted for or reimbursed adequately under current payment systems. Approximately 65 percent of respondents said analysis and reporting was a significant or high burden compared to other laboratory functions, and the step that requires the most time commitment is generally complex analysis.

Technical complexity, additional research requirements, and placing test results in context were the three areas of analysis and interpretation that were most commonly noted as requiring extra effort and the greatest drivers of time burdens.

As for types of testing, single gene tests for human genetics were the only ones where analysis was not conducted at a loss, respondents said. If reimbursement were appropriate for the time spent by laboratory professionals, respondents said they would run faster and more tests, hire more personnel, and offer new tests.

Oncology test results were generally delivered fastest, while whole-genome and exome sequencing test results took significantly longer. Whole-genome and whole-exome sequencing averaged between seven and nine hours of effort related to analysis, interpretation and reporting.

AMP provided five recommendations and possible next steps related to these issues: work to develop informed perspectives on the future testing landscape, including the increasing adoption of more complex tests, and use this data to forecast future analysis burdens on labs; explore case studies to understand how existing analysis burdens impact lab function and how this could increase with anticipated changes; engage with physician and patient groups to better define negative outcomes from slow, expensive, or insufficient testing; advocate for policy changes that will positively impact reimbursement for interpretive services and report preparation for pathologists and qualified doctoral scientists; and educate payors about the complexities of molecular testing and intricacies involved in analysis, interpretation, and results reporting.

AMP said in a statement that the results of the survey "will be crucial" to use in discussions with payors, federal agencies, and members of Congress to advocate for "fair and reasonable reimbursement solutions."

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