ISSUES FACING THE CAP/PATHOLOGY

  • DECLINING REIMBURSEMENT FOR PATHOLOGISTS

  • CHANGING PAYMENT MODELS FOR PATHOLOGY SERVICES

  • SCOPE OF PRACTICE ISSUES

  • CAP BUSINESS NIMBLENESS

  • PRICING CONCERNS FOR PROFICIENCY TESTING AND ACCREDITATION PROGRAMS

  • DIVERSIFICATION OF REVENUE

  • INTERNATIONAL GROWTH

  • NEW TECHNOLOGY (DIGITAL PATHOLOGY, ARTIFICIAL INTELLIGENCE, ETC)

  • ANNUAL MEETING RELEVANCE

  • MEMBERSHIP GROWTH

  • ATTRACTIVENESS OF PATHOLOGY TO MEDICAL STUDENTS

  • REGULATION OF LABORATORY DEVELOPED TESTS

  • LOCAL COVERAGE DETERMINATIONS (LCD)/LAB BENEFIT MANAGER PROGRAMS

  • THREAT OF CLIA BEING REOPENED BY CONGRESS


WHAT WE NEED TO ACCOMPLISH

First and foremost, my goal is to be able to say that the CAP and pathology are in a stronger position when my tenure is over than it was before I was elected. I have worked toward that end for the last 8 years on the CAP Board (3 as a governor and 5 as an officer (Secretary-Treasurer)).

There are a number of issues facing pathology and the CAP. The items listed above are not new and the Board has been working on them to variable degrees for years. However, we appear to be near an inflection point on a number of these issues.

Data has become a huge commodity around the world and the question is can the CAP find a path to monetize the data it currently has or potentially could get. This could be a great opportunity to diversify our revenue stream. But many questions remain as we work to develop a business plan. I am excited about the potential of data and want to focus on fast tracking the most promising opportunities.

Pathology has been under attack from payors, both private and governmental. There is a continuing push for cost sharing, utilization review and/or decreasing reimbursement. Revaluation of the 88300 - 88309 code set appears very likely in the next few years by the AMA RUC (RVS Update Committee) and could be devastating to pathologists and pathology. The CAP is known for its advocacy and its Washington office and Council on Government and Professional Affairs does an excellent job working on behalf of all pathologists and patients. We need to ensure that our advocacy remains strong so that regulators, payors and the public are aware of the importance of pathologists and the value we provide to patients and clinicians through our involvement in the clinical laboratory and pathology. We have got to tell our story.

Compared to most other specialties, Pathology and Laboratory Medicine has been on the cutting edge of quality medical practice since the development of proficiency testing and accreditation standards. As the revenue driver of the CAP, our Laboratory Improvement Program with Accreditation and Proficiency Testing is the reason the CAP can do all it does for pathologists, laboratory medicine and patients. We must continue to evaluate our offerings, competitors and the market to provide innovative solutions that will drive differentiation and a sustainable competitive advantage. But that is not enough. We also need to look for new ways to diversify our revenue so as to limit our exposure to any one service line.

New technology will be incorporated into pathology practice whether we like it or not. Digital pathology use has been increasing and there are a growing number of FDA approved assistive artificial intelligence programs. The CAP must be a driving force in the regulation of artificial intelligence/machine learning as it pertains to pathology. The technology will only improve and we must ensure that it is a tool used by pathologists, not to replace pathologists.

Membership in the CAP has been slowly increasing over the last few years. We need to continue our work on member segmentation and develop programs and products that will push pathologists to choose the CAP over other pathology societies. The CAP must continue maximizing opportunities for member engagement and pursue diversity with appointments. The last few years have seen medical students go into pathology in increasing numbers. We need to continue to improve the CAP’s website search function and develop other ways to meet members where they are. “Just in time” information is the norm these days and CAP’s website should be no different. The CAP has developed so much content over the years, but it’s useless if it is not easily accessible for members.

Regulations from CLIA have helped the CAP and pathologists succeed in the current environment. But what if the rules change? The CAP’s performance is optimized based on certain regulations and market conditions. If the game changes, we have to be able to respond quickly to the new environment or it could be catastrophic.

No matter what we may hope for, the only sure thing in this world is change. The CAP is a classic mature organization that has developed a number of policies and procedures to manage risk and ensure success with the status quo. Unfortunately, those very policies and procedures can make it difficult to embrace new opportunities; especially in a timely manner. The CAP must be more nimble or its risks falling behind in a market that typically punishes inertia.

Every threat is also an opportunity; and we need to make sure the CAP is taking advantage of every opportunity to increase the visibility of pathologists and highlight our value, advocate for fair payment, reduce regulatory burdens, grow the accreditation and proficiency testing programs, diversify our revenue with new products, and listen to members. I want to use my experience to represent the profession to make sure that the CAP is responsive to members, financially sound and preparing for the future.