covid testing cuts

[WEBB PINKERTON]

Glad to see CAP president comment

Trump administration to labs: Finish COVID-19 tests in two days or face payment cuts

Large labs routinely took one week or longer to process coronavirus tests this summer. Medicare will cut payments to labs for delayed test results.

www.usatoday.com

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[Med Director New England]

Fair enough...I agree a Covid test reported 3 + days out is not useful.

the real question imo with Covid reimbursement is whether or not to create a different test code for pooled samples in low prevalence areas or with surveillance testing schemes using molecular testing. labs with large volumes are starting to make tons of $ by pooling 3, 4, or even 5 samples into one test well, and collecting all the reimbursements with a significant reduction of the consumables and human costs.

 

[LADoc00]

Personally Ive felt its best to be all cash, all the time from the get go.

Cash money = COVID status knowledge.

Open a testing center that operates 24-7, co market it with a Denny's or 7-11. Win.

 

[dingdong28]

I don't know how to feel about this. It annoys me because I know my [civilian] lab will not see this reimbursement in our fiscal budget or used for employee appreciation during/after this $hitstorm has ended. It's been 6 months since lab week and we still haven't formally celebrated it yet. It further annoys me because while we're expected to perform all of this testing, we also have to maintain our other departments with a skeleton crew. If our TAT suffers, we're told we have to figure out how to work smarter/together. Where's the support for the people actually performing the testing?

We use the Abbott ID NOW at my [civilian] lab and at times I'm $hitting bricks because we opened our last box of 25 test kits and aren't receiving another box until the next day. Let's also add that the ED insists on performing stat tests on each patient that walks into the ED, regardless if their symptomatic/asymptomatic or being admitted/discharged. I get frustrated when the patient that presents with suicidal ideation NEEDS to have a stat test performed even though they're asymptomatic and will likely be discharged in an hour. Our priority is symptomatic patients, life threatening surgeries that need a rapid test and discharges home and to nursing homes. Why can't we send it to the main lab and have a result back in 12-24 hours? That's we do for blood cultures that come back positive at a later time after the patient's been discharged. We've also received several boxes where the little desiccant packets were broken upon arrival, making several test kits unusable because the little beads got into the kits. We'll be penalized for the sloppiness of the manufacturer.

I'm on a military assignment that's in response to COVID. We process (on average) about 1,200 specimens a day. Since I started this assignment, the highest was a little over 1,700. The majority of these specimens are resulted within 48 hours from collection at whatever base and 12 hours after being accessioned into the LIS. On several occasions, we didn't have enough reagent to perform the test on the Cobas. Thankfully they have a backup molecular test.

 

[LADoc00]

I have several gems Im thinking of going with COVID testing. I think even with a partially successful vaccine, I can see serious legs on this. Like 2-3 years more even.

 

[WEBB PINKERTON]

Easily 2-3 years even more. There will be other players getting involved, Amazon etc.

 

[LADoc00]

Easily 2-3 years even more. There will be other players getting involved, Amazon etc.

Lets say you had a kiosk or string of kiosks and with minimal capital investment and a profit margin of $30 per test, you did 500 day. All cash payments.

Why are you looking at glass at that point? Lets say you did this for even 2 years.

 

[ReedSternburg]

So I felt the need to get a rapid covid test recently. I could've gone through my hospital but that would require taking another day off work (quarantined). Due to the high demand for testing, I could only find one location with immediate availability and rapid resulting. Essentially it was a pop-up testing facility located in a defunct drive-through car wash building with testing performed on site (at the car wash). $375 for PCR and $250 for antigen testing, cash only, no insurance. I think this location was affiliated/owned by a network of urgent care clinics. I made an appointment, got tested two hours later, and got a positive result one hour after that. Given my minimal/no symptoms and low-risk of exposure, I had some reason to doubt the validity of the test. I repeat tested two days later with the test performed in a hospital laboratory. This time the result was negative. Wondering if the pop-up testing site maintained proper protocols to minimize cross-contamination with an ad hoc PCR station set up in a broom closet and possibly staffed by minimum-wage employees.

 

[dingdong28]

So I felt the need to get a rapid covid test recently. I could've gone through my hospital but that would require taking another day off work (quarantined). Due to the high demand for testing, I could only find one location with immediate availability and rapid resulting. Essentially it was a pop-up testing facility located in a defunct drive-through car wash building with testing performed on site (at the car wash). $375 for PCR and $250 for antigen testing, cash only, no insurance. I think this location was affiliated/owned by a network of urgent care clinics. I made an appointment, got tested two hours later, and got a positive result one hour after that. Given my minimal/no symptoms and low-risk of exposure, I had some reason to doubt the validity of the test. I repeat tested two days later with the test performed in a hospital laboratory. This time the result was negative. Wondering if the pop-up testing site maintained proper protocols to minimize cross-contamination with an ad hoc PCR station set up in a broom closet and possibly staffed by minimum-wage employees.

Did you have the antigen test performed at the car wash? I'd be curious to know what type of instrument/test methodology was used at the car wash test facility. As someone that performs lab tests, it's not uncommon for a rapid test to come back positive and a more specific/sensitive test comes back negative. I know it's anecdotal, but I've performed rapid antibody/antigen HIV testing that was positive and the specimen was sent out for a confirmatory testing and came back negative.

Was your repeated test at the hospital the antigen test or PCR? With the antigen tests, I believe it's CLIA waived, meaning anybody can perform the test. I know this is also anecdotal, but I've watched nurses perform a urine pregnancy test and wait only 30 seconds when the test procedure states the test must incubate for 3 minutes. With PCR tests, a qualified medical lab tech/scientist must perform the test or supervise a non-certified lab tech. If your test was performed at the car wash, the kits should be tested and maintained at specific temperature/environmental conditions while strictly following the testing procedure. I'm curious if they were disinfecting the testing surfaces after each test, changing gloves/PPE after each test, etc.

In a perfect world, I would treat this like getting an indeterminate pregnancy test, HIV or any test rest for that matter: Retest the specimen and/or recollect another specimen and test using a different test methodology. Another anecdotal story: I recommended ordering/testing another specimen to one of our hospitalists because their patient had all the signs/symptoms for having covid, but their result was negative when tested with the Abbott ID NOW. I told him to order another test and we'll send it to the main lab for testing (I believe they collected a sputum specimen and NP swab). Both specimens came back positive. Both specimens were collected 24-48 hours after their initial test upon admission.

 

[ReedSternburg]

Both tests were PCR, not antigen.

 

[LADoc00]

Covid test cuts by the government are hilarious, if you aint all cash you aint doing it right folks.

 

[gbwillner]

I was all set to start COVID testing, but at the last minute I thought it would pass after 6 months so it wouldn't be worth the trouble to validate an LDT. In retrospect I just left millions on the table. I has a sad.

 

[LADoc00]

There is time. And cuts are beautiful, the more cuts the more labs will pass the more biz for cash pay there will be. NOW IS OUR TIME FOLKS.

Strike First, Strike Hard, No Mercy.

 

[KeratinPearls]

Start your own Covid testing truck guys and gals. This kid is even doing it! Cmon we’re Pathologists.

Houston High School Student Starts Lab Business and Takes COVID-19 Rapid Antigen Testing on the Road with Mobile Clinical Laboratory - Dark Daily

 

[WEBB PINKERTON]

Definitely a good environment for scammers at the moment.

Plenty of school buses not being used right now. Don't need to buy a Mercedes van.