Labs start to see uptick in volume

LAB MANAGEMENT GROUPS are beginning to see a steady uptick in test volumes, suggesting that the industry, or at least parts of it, could be moving toward a recovery.

Labs began to see a large drop in test volumes in the second half of March as the SARS-CoV-2 pandemic took hold in the U.S.

During Quest Diagnostics’ recent first-quarter earnings call, CEO Steve Rusckowski said the company had seen a testing decline of 50% to 60% inclusive of COVID-19 testing. LabCorp similarly reported testing demand had dropped 50% to 55% by the first quarter’s end.

At the beginning of April, Kyle Fetter, executive vice president and general manager of diagnostic services at revenue cycle management and lab informatics firm Xifin, echoed the reference labs’ reports, noting that his firm had seen drops ranging from around 20% to more than 50% depending on the type of testing.

Recently, though, Xifin has seen a rise in testing, with, according to the company’s data, volumes beginning to go up again the week of April 6. At the beginning of that week, test volumes were just over 40% of their normal baseline (as established by average volumes in January and February of 2020) excluding COVID-19 testing and at 60% of baseline when including those tests. As of mid-May, test volumes for the company’s clients had risen to 56% of their baseline excluding COVID-19 testing and to 91% overall.

“We are seeing (testing) trickle back in,” Fetter said. “I don’t know that we are sitting here thinking that suddenly things are going to return to normal.

But what appears to be happening right now is slowly, doctors’ offices are getting reengaged and that means the (test) volumes are going to start to ramp back up again.”

He noted the uptick was more pronounced in some specialties; noninvasive prenatal testing and clinical genetics had solid volume increases, while areas like anatomic pathology and toxicology remained sluggish.

Fetter said the company also saw differences based on geography, with testing appearing to return more rapidly in the Midwest compared with the coasts, though he noted that volumes are up somewhat even in the country’s hardest-hit parts, like the Northeast.

He suggested that in addition to the gradual reopening of doctors’ practices, the rise in test volumes was driven by the fact that some patients can no longer safely delay testing they had avoided during the earlier stages of the pandemic.

“You can only defer some of this testing for so long before it creates a more negative impact” than COVID-19 itself, he said. “Certainly, there is a lot of testing that goes on every day just to kind of keep people going, and that is the kind of testing that we are seeing start to return.”

David Nichols, president and founder of lab services consulting firm Nichols Management Group, added that routine testing volumes were “slowly returning, especially correlated to the resurgence of discretionary surgery” and other non-urgent medical procedures.

“There has been a spike in the last couple of weeks due to antibody testing, but I don’t think that is going to continue,” he said, attributing the spike in large part to people who had had colds or flu during the winter wanting to learn if they have been exposed to COVID-19. “They went and got their antibody tests, and if it was negative, they aren’t going to get tested again.”

Additionally, point-of-care and homebased protein antigen tests will likely compete with lab-based polymerise chain reaction testing for the virus in coming months, Nichols said, which could negatively impact lab volumes even as overall demand for SARS-CoV-2 testing rises. He said he also expected that Medicare pricing for COVID-19 tests will be reset at lower rates next year.

He suggested that longer term the virus would likely boost testing volumes, especially if, as some are predicting, infections recur on a seasonal basis much like the flu. ●