If enacted, this fee cut is predicted to cost medical laboratories €316M Annually and eliminate about 8,000 jobs in that nation

Clinical laboratories here in the United States are not alone in their struggle maintain quality as declining reimbursements from private and government health programs force cost-cutting measures. In France, medical laboratories have learned that they will soon see a sizeable cut in reimbursement paid to them for lab testing services.

This summer, France’s Cour des comptes (French Court of Auditors) called for cutting tariffs to medical laboratories by 7.5%, according to a report published by The Connexion.

Price Cuts Justified by Overutilization of Medical Laboratory Tests

To justify its decision, the Cour des comptes cited vast increases in the number of certain medical laboratory tests. For example, it called attention to the 60% increase in volume of clinical laboratory tests ordered for vitamin D levels over the last 10 years. In France, there is also a problem with duplication in the number of medical tests ordered.

€316M in Cuts to Lab Fees Threaten 8,000 Jobs

There will be widespread pain from these cuts in reimbursement, stated Francois Blanchecotte, noting that cuts would cost medical laboratories about €316 million (US$481 million) annually. As many as 8,000 jobs may be lost, noted Blanchecotte. He is the Président of the Syndicat des Biologistes, which is one of three professional groups representing French laboratories. Blanchecotte is also Vice President of the Union Nationale des Professions de Santé (National Union of Health Professionals).

Francois Blanchecotte (pictured above), Président of the Syndicat des Biologistes is an advocate for French medical laboratories. He says that the Cour des comptes’ call for a 7.5% reduction in reimbursement to hospital medical laboratories came as a surprise, since his organization was close to finalizing an agreement that would have increased lab fees by 0.5% over three years.  (Photo copyright Union Nationale des Professions de Santé.)

Francois Blanchecotte (pictured above), Président of the Syndicat des Biologistes is an advocate for French medical laboratories. He says that the Cour des comptes’ call for a 7.5% reduction in reimbursement to hospital medical laboratories came as a surprise, since his organization was close to finalizing an agreement that would have increased lab fees by 0.5% over three years. (Photo copyright Union Nationale des Professions de Santé.)

Blanchecotte told The Connexion that the government announcement came as a surprise. That’s because his organization had been close to finalizing a new agreement with Assurance Maladie, the nation’s healthcare system. This agreement would have seen a rise of 0.5% in expenses for medical laboratory tests during the next three years.

The report noted that physicians in France were also told to avoid duplication of medical laboratory tests. The Cour des Comptes estimated that a 15% decrease in unnecessary lab tests could save up to €300 million a year.

The move to cut reimbursement to medical laboratories was instigated by the French Senate’s Social Affairs Committee. It is designed to help reduce the deficit of Assurance Maladie. Estimates are that this action may generate annual savings of about €220 million.

England Consolidating Lab Services into ‘Super Labs’

Balancing the healthcare budgets on the backs of medical laboratories is a growing trend.  Last year, government health administrators in both England and Australia began closing hospital-based clinical labs to achieve economies of scale. Medical laboratory closures in both countries have been in small communities, where a full-service lab testing facility was not economically justifiable. Patients’ specimens from these communities are now processed by the core lab facilities  in larger communities. (See Dark Daily, “Budget Cuts Mean More Clinical Pathology Laboratory Closures in Some Developed Countries,” December 21, 2012.)

To help ensure the sustainability of the United Kingdom’s National Health Service (NHS), a review by NHS Pathology Services had recommended establishing “managed pathology networks” to operate clinical laboratories. The idea was to consolidate medical laboratory testing services in an effort to improve quality and cost effectiveness. The decision to establish regional super labs to service hospitals in small surrounding communities was intended to be a step in this direction.

Australians Restructuring Hospital Labs, Laying off Staff to Save Money

Similarly, state governments in Australia have closed clinical laboratories in selected hospitals and axed laboratory staff to reduce healthcare costs, noted the Dark Daily article. For example, the Queensland State Government’ Department of Health restructured pathology services last year and eliminated 105 laboratory jobs.

From a wider perspective, it is no coincidence that government health officials in France, United Kingdom, and Australia are taking similar steps to cut the cost of medical laboratory testing. All developed countries are seeing an increased demand for healthcare services that outstrips the ability of these countries to pay for that care.

—Patricia Kirk

Related Information:

Laboratory fees face cut

Budget Cuts Mean More Clinical Pathology Laboratory Closures in Some Developed Countries