Medicaid Cuts and the Future of Respiratory Testing: Why Flexibility Is the New Imperative

By Stephanie Ibbotson

Healthcare’s new reality: How labs can stay resilient with smarter, more flexible testing approaches

The healthcare industry is once again facing a seismic shift. The passage of the One Big Beautiful Bill Act (OBBB) in July 2025 introduced sweeping changes to Medicaid and the Affordable Care Act (ACA), with $1 trillion in cuts projected through 2034, including $665 billion directly impacting hospitals.1 These changes are expected to reshape the financial landscape for clinical laboratories, hospitals, and diagnostic providers, especially those serving vulnerable populations.

What’s changing, and why it matters

The OBBB introduces:

  • Stricter Medicaid eligibility requirements, including mandatory work verification.
  • Reduced federal matching funds for hospitals serving Medicaid populations.
  • Provider tax reforms that limit state flexibility in funding care.
  • Expiration of ACA marketplace subsidies, potentially leaving millions uninsured.2

For clinical labs and hospitals, this means:

  • Fewer covered patients and more uncompensated care.
  • Reduced reimbursement for diagnostic testing.
  • Increased pressure to optimize operational efficiency and cost-effectiveness.

Respiratory testing, already complex due to overlapping symptoms and seasonal variability, is particularly vulnerable. With declining reimbursement, tighter budgets, and shifting patient coverage, labs must rethink how they deliver high-quality diagnostics without compromising care.

The strategic response: smarter, more flexible testing

In this new reality, flexibility isn’t a luxury; it’s a necessity. Labs and hospitals need diagnostic platforms that:

  • Adapt to changing patient volumes and payer mixes.
  • Support diagnostic stewardship by aligning testing with patient population and clinical needs.
  • Reduce waste and improve cost-efficiency.

This is where Diasorin’s comprehensive respiratory molecular testing portfolio, the LIAISON PLEX® Respiratory Flex Assay and Simplexa® Direct respiratory suite, can contribute to building a reliable and flexible testing approach.

Introducing LIAISON PLEX®: a smarter way to test

The LIAISON PLEX® Respiratory Flex Assay is a sample-to-answer, multiplexed molecular test that detects up to 19 respiratory pathogens, including SARS-CoV-2, influenza, RSV, and bacterial targets, from a single nasopharyngeal swab.3

Key benefits for today’s healthcare environment

  • Customizable Panels: Choose only the targets relevant to your patient population or clinical presentation. Pay only for what you report.
  • Rapid Turnaround: Deliver results in under 2 hours with <2 minutes hands-on time, thereby streamlining workflows and reducing labor costs.4
  • Diagnostic Stewardship: Align testing to institutional guidelines, seasonal trends and/or clinical presentations to support smarter care and better resource allocation.
  • Cost-Conscious Design: Built for labs managing tighter reimbursement and budget constraints, especially in Medicaid-heavy regions.
  • Adaptability without Sacrificing Quality: Create tailored panels that align with provider and network needs.

Simplexa®: targeted testing for critical needs

While LIAISON PLEX® offers flexibility for syndromic respiratory testing, Simplexa® (performed on the LIAISON® MDX) complements this approach by delivering rapid, targeted molecular solutions for high-priority pathogens.

  • Respiratory Testing: Simplexa assays provide fast, accurate detection of key respiratory pathogens for labs that need streamlined workflows without large multiplex panels.
  • Beyond Respiratory: Emerging pathogens like Candida auris, a multidrug-resistant fungus with high mortality rates, and congenital CMV, a leading cause of birth defects, underscore the importance of precision diagnostics. These conditions often affect vulnerable populations, including newborns, immunocompromised patients, and individuals in long-term care, many of whom are disproportionately impacted by Medicaid cuts.
  • Flexible Testing Approaches: Multiplex platforms can support testing for these pathogens in specific sample types. However, a more targeted approach is often needed to enable early intervention, uphold stewardship principles, and manage costs.
  • Simplexa Portfolio: Testing on the LIAISON MDX delivers that targeted capability, helping labs obtain clinically actionable results without unnecessary complexity or expense.

Conclusion: resilience through innovation

Medicaid cuts are reshaping the healthcare landscape, but labs and hospitals can adapt and thrive with the right tools and partners. Diasorin’s respiratory and targeted diagnostic solutions, LIAISON PLEX and Simplexa, offer future-ready options that balance clinical excellence with economic sustainability.

Let’s build your testing strategy together

At Diasorin, we understand that every lab and hospital faces unique challenges. That’s why our Market Access team is here to help you:

  • Assess the impact of Medicaid changes on your diagnostic operations.
  • Model cost-efficiency scenarios using LIAISON PLEX and Simplexa.
  • Develop tailored testing strategies that align with your clinical and financial goals.

Whether you’re a rural hospital, a high-volume reference lab, or a health system navigating reimbursement shifts, we’re ready to partner with you.

Connect with our Market Access team by emailing MarketAccess@diasorin.com to explore how Diasorin solutions can support your testing strategy.

References:

  1. https://www.congress.gov/bill/119th-congress/house-bill/1/text
  2. https://www.hfma.org/fast-finance/regulatory-changes-hospitals-financial-impact/
  3. https://us.diasorin.com/en/molecular-diagnostics/kits-reagents/liaison-plex-respiratory-flex-assay
  4. https://www.captodayonline.com/fda-clears-diasorin-liaison-plex-system/

PASCV Podcast Recap: How Flexible Syndromic Respiratory Panels Are Transforming Diagnostic Stewardship

By Diasorin Product Management

PASCV’s “Gone Viral” Episode 12: Flexible and Customizable Molecular Panels offers insights into implications for reimbursement alignment, smarter reflex testing, and practical lab strategies

In Episode 12 of PASCV’s Gone Viral podcast, an expert panel of Clinical Microbiology Laboratory Directors and infectious disease experts explored how flexible syndromic panels are reshaping diagnostics. What was at the center of the conversation? Diasorin’s LIAISON PLEX® Respiratory Flex Assay (RSP Flex), a purpose-built solution for labs navigating rising costs, staff shortages, and evolving clinical needs. We’ve included some key highlights from the discussion.

Podcast Panelists

  • Dr. Logan Patterson, PhD, D(ABMM), Medical University of South Carolina (MUSC)
    Host and Director of Microbiology and Molecular Microbiology
  • Dr. Heba Mostafa, PhD, MD, Johns Hopkins University
    Assistant Professor of Pathology, Director of Molecular Virology
  • Briana Castillo, MD, MS, Massachusetts General Hospital (MGH)
    Infectious Disease Physician
  • Phyu Thwe, PhD, D(ABMM), Montefiore Medical Center
    Associate Director of Infectious Disease Testing, Associate Professor
  • Nicholas Decker, MBA, MLS(ASCP), Holland Hospital & CoxHealth System
    Administrative Director of Laboratory Services

What are flexible syndromic panels, and why are they important?

Episode 12 Insights: The conversation began with Dr. Heba Mostafa breaking down what syndromic panels are—tests that look for multiple pathogens tied to a specific disease state, like respiratory infections.

Diasorin’s Perspective: Fixed syndromic panels frequently include unnecessary targets, especially for immunocompetent or outpatient populations, often wasting resources, and slowing workflows. Enter customizable panels. Rather than always running a 22-target panel, what if labs could tailor the test based on patient type, season, or local prevalence? That’s the promise of flexible syndromic panels like the LIAISON PLEX RSP Flex. It gives labs the flexibility to run what’s relevant and avoid over-testing.

Are labs already using customizable panels?

Episode 12 Insights: Nicholas Decker’s lab has implemented the LIAISON PLEX RSP Flex Assay and shared that his lab underwent a full seasonal respiratory cycle, initially launching with age-specific panels, which his team later adapted mid-season in response to shifting pathogen trends. “At the initial launch we hadn’t considered a panel of simply Bordetella and Mycoplasma together… But due to prevalence and due to what we were seeing mid-season we opted to build that panel to get that access to our clinicians,” Decker stated. Additionally, Dr. Patterson noted, “Having simplicity and being able to streamline that testing to do all the major targets on one platform is a huge advantage. It’s a lot less headache as a director and as a laboratory manager to not have to deal with the validations of proficiency testing of all the different platforms.” Other labs, like Dr. Mostafa’s at Johns Hopkins, evaluated the LIAISON PLEX RSP Flex platform and have since published their findings, while Dr. Phyu Thwe’s team use LIS-based workarounds. Dr. Castillo described an algorithm-based ordering system.

How do you decide which targets go into your top-tier panel?

Episode 12 Insights: This question sparked much agreement: choosing the right tier one targets isn’t one-size-fits-all. Dr. Mostafa said her team looks at local seasonal trends, population-specific data, and clinical relevance. Dr. Castillo added that infection control policies also shape what’s needed in tier 1 versus tier 2 testing.

Diasorin’s Perspective: The LIAISON PLEX RSP Flex offers customizable panel configurations with up to seven tier one targets, allowing labs to tailor testing to actual needs rather than manufacturer defaults.

Can customization become too complicated?

Episode 12 Insights: Host Dr. Logan Patterson asked the million-dollar question: Do you end up with so many panel variations that it’s just easier to run a full panel? Not quite. Most labs stick to a basic structure—like a five-target core panel and a broader full panel for sicker or admitted patients. Nicholas Decker’s team began with four defined panels, adding a fifth panel mid-season based on rising Mycoplasma and Bordetella cases.

Diasorin’s Perspective: The LIAISON PLEX RSP Flex makes this easier by offering unmatched target customization—without adding new instrumentation, LIS burden, or validations.

How often should you update your targets?

Episode 12 Insights: Panelists agreed that updates should reflect clinical and epidemiologic data, but IT resources can be a bottleneck. Nicholas Decker likened it to seasonal “campaigns”, using historical data to guide panel shifts.

Diasorin’s Perspective: With the LIAISON PLEX RSP Flex, you choose the targets that are reported and analyzed, so you can build panels in advance and instantly reveal additional results as needed, without repeating the sample run.

How do you help providers understand what they’re ordering?

Episode 12 Insights: This sparked a candid discussion. Dr. Castillo admitted that if she sees “respiratory panel” in the EMR, she expects a full panel. But when she receives five results instead of 20, it can be confusing. Panelists stressed the importance of naming conventions, showing included targets, and embedding educational cues in the EMR.

Diasorin’s Perspective: Ideally, the ordering process should be intuitive, something that the LIAISON PLEX® System supports through its software-guided test selection and reflex algorithms.

Can reflex rules be automated?

Episode 12 Insights: Most labs avoid fully automated reflex rules due to reimbursement and compliance concerns. Instead, they require provider input before escalating to a full panel. However, all agreed that their dream is a platform that can test all targets upfront, then report more if requested—without rerunning the test.

Diasorin’s Perspective: That’s exactly how the LIAISON PLEX works. The system simultaneously processes all targets in one run, and results can be analyzed and released immediately on demand—saving tech time, reducing operational costs, and improving turnaround for clinical decisions.1

Is there a place for a middle tier of testing?

Episode 12 Insights: There was no consensus here. Nicholas Decker and Dr. Mostafa’s labs reflex directly from small to full panels, while Dr. Castillo sees value in intermediate tiers—if supported by stewardship oversight, clear pricing, and education.

Diasorin’s Perspective: The LIAISON PLEX RSP Flex gives labs the ability to design any panel menu strategy they want, without operational or financial penalty. Thanks to tiered pricing, the total cost of the test is based on the final number of targets reported—so labs can scale panels up or down as needed and only pay for what they use. This flexibility can significantly reduce costs compared to fixed syndromic testing strategies, where every target is paid for regardless of clinical relevance.

How do you deal with reimbursement limitations?

Episode 12 Insights: Many payors only cover 3–5 targets, especially for outpatients. Nicholas Decker commended the LIAISON PLEX RSP Flex’s tiered pricing structure, which allows institutions to stay within reimbursable levels while still customizing target selection. Some labs even added “dollar signs” in the EMR to help clinicians understand cost differences between panel options.

Is it ethical to hide results that were technically run?

Episode 12 Insights: Dr. Patterson raised a tough question: if the platform amplifies all targets but only reports five, is it ethical to “hide” positives that go unreported? Dr. Mostafa clarified that with LIAISON PLEX, unselected targets aren’t analyzed unless requested.

Diasorin’s Perspective: There’s no ‘hiding’— just a more efficient and compliant approach that helps labs stay ethical while avoiding unnecessary retesting.

How do you know when to update your panel to catch emerging pathogens?

Episode 12 Insights: Dr. Logan Patterson noted that this capability supports epidemiological decision-making. Meanwhile, Nicholas Decker imagined a future where the Flex® Software could proactively flag rising background positives, triggering alerts to review or modify panels, which would take diagnostic stewardship to the next level.

Diasorin’s Perspective: This is where the LIAISON PLEX really shines. Software currently in development will enable aggregate review of all targets, allowing labs to dynamically adjust panel configurations in response to emerging trends—such as spikes in Bordetella or Mycoplasma.

Diasorin’s Final Thoughts

Wrapping with enthusiasm, the panel offered some wish list ideas for vendors—like simplified reflex workflows, integrated education, and smarter software prompts. But across the board, the panelists agreed: flexible syndromic testing is here to stay.

The LIAISON PLEX RSP Flex makes precision testing easier by offering unmatched target customization—without adding new instrumentation, LIS burden, or validations.

LISTEN TO THE EPISODE

LEARN MORE

 

1) Norton, J. M., Dashler, G., Klein, E., & Mostafa, H. H. (2025). The utility of syndromic respiratory pathogen panels: The premise of flexible and customizable approaches. Journal of Clinical Microbiology, 63(7). https://doi.org/10.1128/jcm.00313-25.

Potential Impact of Flexible Respiratory Testing: Clinical and Economic Benefits

By Steve Michalik

Accurate, timely diagnosis of respiratory infections is essential, but traditional syndromic panels—testing all pathogens every time—can be costly and often clinically unnecessary

Their use of complex two-step algorithms, where a small, targeted panel is run first and followed by a broader syndromic panel if negative, can significantly delay results. As a result, fixed syndromic panels are frequently limited to inpatient use only.

Bridget Parsons, MSPH, Market Access Manager at Diasorin, recently shared in a presentation at ADLM how the LIAISON PLEX® Respiratory Flex Assay is transforming the way laboratories, hospitals, and clinicians approach respiratory diagnostics. Her message is clear: you shouldn’t have to choose between clinical answers and financial sustainability.

Why flexibility matters

As Parsons explained, unlike traditional, fixed syndromic panels, the Flex™ Testing approach allows laboratories and healthcare providers to:

  • Customize the test menu to meet patient and institutional needs.
  • Align testing with guidelines and reimbursement requirements.
  • Support diagnostic stewardship by focusing only on pathogens relevant to the clinical picture.

This translates to reduced unnecessary testing and smarter use of resources.

Real world impact

The impact of flexible respiratory testing is best seen through real-world examples across different healthcare settings.

At academic medical centers, where patient populations are diverse and testing needs shift with the seasons, targeted panels have proven to maximize diagnostic yield. In a retrospective analysis of respiratory testing prevalence data, one medical center found that it could have captured 92% of positive cases using a smaller prevalence-driven panel with only 8% requiring additional follow-up testing. The result of shifting that testing to a smaller panel would have amounted to >$300,000 of testing costs that could have been redirected to a flexible testing strategy. This would have conserved resources without compromising diagnostic yield, demonstrating that smarter panel design can deliver both efficiency and accuracy.1

In community hospitals, the story is one of tailoring diagnostics to the setting. Rather than running large multiplex panels for every patient, clinicians can rely on small, focused panels designed for specific environments such as pediatric or adult emergency departments, or outpatient clinics. Larger panels are reserved only for the most vulnerable patients, e.g., those who are immunocompromised, aging, or severely ill. By shifting to this targeted approach, one hospital reduced the number of full syndromic tests by more than half. Using a market average for a syndromic panel of $139, this would have represented a reduction in syndromic testing costs of more than $100,000. The resulting savings could be used toward a more targeted testing strategy while still ensuring that patients received care that was timely, relevant, and precise.2

Meanwhile, commercial laboratories benefit from a model that combines a reliable base panel with a menu of flexible add-ons. This structure allows labs to adapt to client needs, regional prevalence patterns, and even seasonal changes in respiratory illness. By offering this level of customization, laboratories can expand their service offerings while maintaining operational efficiency—a win-win for both the lab and its clients.

The benefits at a glance

Across these settings, the advantages of flexible testing come into sharp focus. Speed and accuracy improve as automated workflows reduce hands-on time and deliver faster results. Adaptability is built in, with panels that can shift according to seasonal trends, patient demographics, or institutional protocols. Costs are optimized by avoiding redundant testing and aligning with dynamic reimbursement guidelines. Most importantly, patient care is elevated: by focusing on the most relevant pathogens, providers can support diagnostic stewardship and ensure that patients receive the right treatment sooner at a reduced out-of-pocket cost.

One panel. Endless possibilities.

Respiratory testing doesn’t need to be “all or nothing.” With the LIAISON PLEX® Respiratory Flex™ Assay and Flex Testing, healthcare providers gain the freedom to tailor diagnostics, reduce unnecessary costs, and deliver the high-quality care patients deserve.

Watch the ADLM Presentation

For more information, contact: MarketAccess@diasorin.com

To read more about how LIAISON PLEX RSP Flex is changing respiratory testing, check out these other blogs:

Advancing Respiratory Diagnostics: Customization and Cost Control with the LIAISON PLEX® System

“Smarter Diagnostics” with a Flex™ Respiratory Testing Approach

From Fixed to Flexible Syndromic (Flex™) Testing: Lessons from Norton et al. on Advancing Respiratory Diagnostics

  1. Pancholi, P., & Parsons, B. (2025, June 22). Potential Benefits of Timely, Flexible, and Cost-Effective Respiratory Pathogen Testing During a Public Health Outbreak [Poster presentation]. ASM 2025 Los Angeles, CA, USA.
  2. Parsons, B. (2025, July 29). Potential Impact of Flexible Respiratory Testing: Clinical and Economic Benefits. [Conference presentation]. ADLM 2025 Chicago, IL, USA.

Beyond the Result: Podcast Episodes 3 & 4 Focus on Value-based Care and Targeted Testing

By Stephanie Ibbotson and Molly Frazier

Experts from Washington University in St. Louis and Cedars-Sinai in Los Angeles share their perspectives on trends and priorities in laboratory medicine

Diasorin’s Beyond the Result podcast has been a hit with the clinical laboratory community, and we’re grateful to everyone who has taken the time to watch or listen. These podcast discussions, featuring our own Angelo Rago speaking with a guest expert on topics ranging from diagnostic stewardship to clinical decision support, are an important resource for a community that’s already stretched thin and continually being asked to do more with less.

That’s why we’re excited to share the release of two new podcast episodes: one with Mark Zaydman, MD, PhD, from Washington University in St. Louis, and the other with Margie Morgan, PhD, from Cedars-Sinai in Los Angeles.

Value-based care depends on defining and measuring value

Dr. Zaydman serves as an assistant professor of pathology and immunology in the Division of Laboratory and Genomic Medicine. In the podcast episode, “Value Matters: Measuring What Counts in Lab Medicine,” he and Angelo discuss the transition to value-based care, keeping the focus on the patient, and promoting diagnostic stewardship.

Dr. Zaydman notes that achieving a healthcare system based on value would not be feasible without the ability to define and measure that value. “We know we need to move away from fee-for-service and focus on value, but we don’t have a consensus about how to define value, who the value is for, and how we measure it,” he says. “That’s kind of a precarious position.” Without those clear definitions, Dr. Zaydman adds, the focus on value is often misinterpreted as cost-cutting without a clear patient benefit.

In laboratory medicine, establishing value requires understanding how a clinician will use any test result, and whether those results will lead to real changes in patient care. Unfortunately, it isn’t easy to ascertain those details across every clinician and every type of test. Dr. Zaydman recounts conversations with clinicians about what they’d do with a positive result, and how that would differ from what they’d do with a negative result. “These conversations are really informative about how lab medicine matters, but one-on-one calls like this are very expensive,” he says. It’s almost impossible to scale from those conversations to something equally substantial about all test algorithms. “This is all-hands-on-deck time,” he adds.

Another challenge Dr. Zaydman identifies is getting alignment across numerous stakeholders in the healthcare system, many of whom are accountable for widely varied goals. “Putting the patient at the center, and their best outcomes as the goal, is the only way we can align,” he says.

Hear this and more from Dr. Zaydman on Beyond the Result Episode 3 or wherever you find your podcasts.

Targeted, flexible testing is more appropriate and cost-effective than syndromic panels for most patients

In the podcast episode “Speed Meets Strategy: Rapid Results, Smarter Decisions,” Angelo speaks with Dr. Morgan, director of clinical microbiology at Cedars-Sinai. Their discussion covers the challenges of delivering top-notch care to a large patient population with diverse needs, finding ways to guide physicians to use the most appropriate and cost-effective test without relying solely on syndromic panels, and teaming up with clinical counterparts to achieve more.

At Cedars-Sinai, the laboratory team is responsible for developing and delivering the right test for a wide variety of care scenarios. “That makes for an interesting but difficult landscape to develop the right test,” Dr. Morgan says. “No one size fits all. Sometimes you want to use a large multiplex panel, and other times that’s the last thing you would use. We have to look at all these situations and try to develop the right thing to do for each patient.”

Dr. Morgan also has to push back against clinicians’ ingrained instincts to order syndromic testing for all patients. “There was a time when we thought more is better,” she says. “That’s not the right way to go about things these days. That’s why stewardship is so important.”

By collaborating with infectious disease experts and the infection control team, she and her lab established “soft stops and hard stops” in the test ordering system to help guide users to the most appropriate test for each situation. For example, a large multiplex respiratory panel can only be ordered for ICU patients — not for outpatients or non-ICU inpatients. Another clever technique that has been very effective: Dr. Morgan rearranged the placement of tests on the ordering screen, putting the more targeted tests at the top and the syndromic panels toward the bottom. “That has eliminated some of our issues,” she states, noting that it helps to avoid high-priced syndromic panels that are unnecessary for the situation and might be financially burdensome for patients. Her team has implemented Flex™ Testing to enable the development of custom panels, including targeted mini panels, to provide as much flexibility as possible for cost-effective testing options.

Hear this and more from Dr. Morgan on Beyond the Result Episode 4 or wherever you find your podcasts.

Stay tuned!

Beyond the Result Podcast >

Discussions on the Beyond the Result are happening monthly, with future guests including:

  • Kyle Rodino, PhD, D(ABMM) Assistant Professor of Clinical Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania
  • Gabriel Bien-Willner, MD, PhD, Medical Director, MolDX; Chief Medical Officer at Palmetto GBA

Whether you’re a healthcare executive, decision-maker, or laboratorian, “Beyond the Result” is your front-row seat to the future of diagnostics—because better diagnostics means better care.

Sign up to be notified when new episodes become available.

Diasorin: Your Partner in Market Access

By Bridget Parsons

Market Access supports lab decision making with strategic insight

When a new molecular test comes on the market, clinical validity and turnaround time are often the first aspects most labs consider. However, these additional considerations matter just as much:

  • Will we be reimbursed for running this assay?
  • Would our providers actually order it?
  • Can running this test be financially sustainable, or would we lose money running it?

This is where Market Access comes in.

What is Market Access, and why does it matter?

Market Access refers to how tests gain coverage, reimbursement, and broader adoption across healthcare systems. Even if you’re not directly negotiating with insurance providers, Market Access directly affects many aspects of your work, including:

  • Your bottom line: Denials and low reimbursement lead to time consuming appeals and ultimately lost revenue.
  • Operational confidence: If a test is seen as high-risk for denial from insurance providers, it’s more difficult to justify ordering it.
  • Patient and provider satisfaction: Providers want to offer tests that are covered by insurance and won’t lead to high bills for their patients.

Market Access guidance supports success

With tightening budgets, evolving coverage policies, and increasing demands on labs to prove value as well as performance, Market Access is no longer a downstream issue; it’s part of the adoption conversation from the start.

Market Access consultation can help labs better address the following:

  1. Reimbursement clarity
    Labs are increasingly cautious about adding new tests, especially if CPT coding is unclear or denial rates are high. A test with clear billing guidance and support is much easier to greenlight than one without.
  2. Test utilization strategy
    Tests that let you choose the right panel size or adapt to clinical questions help your lab align better with payer expectations. That flexibility can reduce unnecessary denials and increase clinician satisfaction.
  3. Workflow efficiency
    If a new test streamlines sample handling, integrates easily with the laboratory/hospital information system (LIS/HIS), or reduces instrument clutter, it’s a win for everyone involved. However, it’s only sustainable if the reimbursement supports the investment.
  4. Support from commercial partners
    Diasorin offers reimbursement education, coding support, reimbursement appeal templates, and more to reduce your lab’s financial risk and administrative burden.

At Diasorin, providing a testing solution is only the beginning of the relationship. We stay in the trenches with our customers to navigate the complex realities of coding, coverage, and reimbursement. Our Market Access team works side-by-side with your lab to anticipate payer requirements, provide practical reimbursement tools, and equip your staff with the knowledge to maximize coverage and minimize denials. This hands-on approach is a differentiator in the diagnostics industry—because we know that your success isn’t just about clinical performance, it’s about ensuring the test you run is also one you get paid for.

Partner with our Market Access team to explore smarter solutions

Market Access may not be in your job title, but it’s in your day-to-day reality. A great test is only part of the equation. The rest is about knowing you’ll be supported—not just clinically, but operationally and financially.

Interested in receiving Market Access guidance for your lab? Here are the next steps for you to consider:

  • Review coding and coverage, not just reimbursement rates for tests before you commit.
  • Talk to your commercial partners about what education, support, and reimbursement resources they provide.
  • Start conversations early to ensure you align your clinical, operational, reimbursement strategy proactively.

 

To explore how our solutions fit your clinical and economic goals, reach out to our team at MarketAccess@diasorin.com to schedule a consultation today.

 

Read more from our Market Access team:

  1. A Flexible Model Is Necessary for Today’s Respiratory Testing
  2. The Post-Emergency Reimbursement Landscape for COVID-19 Testing
  3. For GI Testing, Targeted Panels Meet Today’s Reimbursement Criteria

Advancing Respiratory Diagnostics: Customization and Cost Control with the LIAISON PLEX® System

By Steve Michalik

A Stewardship-Centered Approach to Respiratory Diagnostics: Cedars-Sinai’s Strategy with Dr. Margie Morgan

Traditional syndromic respiratory testing has long followed an “all-or-nothing” approach—offering broad menus at a premium price, regardless of what the clinician actually needed. But at an ASM Microbe 2025 Industry & Science Showcase, Dr. Margie Morgan of Cedars-Sinai Medical Center presented a smarter, more cost-effective alternative: the LIAISON PLEX® Respiratory (RSP) Flex Assay. While the 50% cost savings she cited—cutting expenses from $130,000 to $65,000 per 1,000 samples—were based on data from the VERIGENE® Respiratory Pathogens (RP) Flex Test compared to fixed panels, even greater savings are anticipated with LIAISON PLEX due to its advanced automation, broader test menu, and customizable panel design.

Watch Dr. Morgan’s presentation.

A Paradigm Shift: One-Size-Doesn’t-Fit-All Testing

At Cedars-Sinai, the microbiology team was under growing pressure to reduce testing volume and costs, especially for high-volume assays like respiratory panels. Traditional fixed panels often included far more targets than needed, leading to over-testing and unnecessary costs.

The LIAISON PLEX RSP Flex Assay changed the game by offering unmatched customization:

  • Build any test menu: The panel can be tailored to seasonal trends, patient demographics, and clinical algorithms. Whether you need a focused 7-target panel for general medicine or a broader 19-target panel for ICU patients, the system supports it all—without requiring new hardware or validations.
  • Only pay for what you report: Thanks to Diasorin’s proprietary Flex® Software, labs are billed only on the number of targets reported. This tiered pricing model drastically reduces costs, especially in outpatient and outreach settings.
  • Instant access to unreported results: If additional information is needed later (e.g., if a patient’s symptoms worsen), labs can unlock more target results from the same initial run—no second swab, no re-testing, and no added burden on staff.
  • Run any panel size on a single platform: Run all custom panels on a single, scalable system, minimizing training, maintenance, and inventory.

Cedars-Sinai’s Implementation Strategy

By customizing the LIAISON PLEX RSP Flex Assay to fit Cedars-Sinai’s clinical and financial needs, Dr. Morgan’s team achieved:

  • Strategic use of focused panels for general wards, with broader panels reserved for high-risk or immunocompromised patients
  • Reduced reliance on send-out testing for targets like Mycoplasma pneumoniae.
  • A single platform to support multiple respiratory testing algorithms across departments

These changes weren’t just administrative; they were rooted in robust collaboration between ID specialists, stewardship committees, and lab leadership. And they delivered results: lower costs, greater physician satisfaction, and improved diagnostic yield aligned with real-time local pathogen trends.

Why LIAISON PLEX RSP Flex Is the Future of Syndromic Testing

Traditional fixed syndromic respiratory panels are expensive, rigid, and operationally inefficient. In contrast, the LIAISON PLEX RSP Flex Assay on the LIAISON PLEX® System offers flexible syndromic testing (Flex):

  • Custom panel design for any patient population
  • Dramatic cost savings through pricing based on the number of targets reported
  • On-demand reflex testing performed from the initial specimen

This model supports true diagnostic stewardship at the right price.

Key Takeaway:

The LIAISON PLEX® RSP Flex Assay empowers clinical labs to abandon the one-size-fits-all approach to take control of their testing needs. With customizable panels, flexible pricing, and real-time access to additional results, LIAISON PLEX RSP Flex is not just a better test, it’s a better strategy.

Watch Dr. Morgan’s presentation.

ASM Releases Evidence-Based Guidelines for Rapid Bloodstream Infection Testing

By Diasorin

Recommendations include evidence from scientific literature to inform best practices in rapid diagnostics and communication of results

New ASM Guidelines Aim to Improve Bloodstream Infection Testing and Sepsis Outcomes

New recommendations from the American Society for Microbiology on bloodstream infection testing are designed to help clinical laboratory teams make effective decisions about how to deliver optimal results and improve the outcomes of patients at risk of sepsis. The recommendations should also prove useful to pharmacists, infectious disease clinicians, hospital administrators, and other members of the clinical community.

This report is much needed and has been a long time coming. ASM first attempted to achieve consensus on recommendations back in 2016, but at the time, its expert panel determined that there was insufficient evidence in the scientific and clinical literature to define best practices in rapid diagnostic testing for bloodstream infections. Nearly a decade later, ASM teamed up with the Centers for Disease Control and Prevention and Battelle to assemble a new panel tasked with conducting a review and meta-analysis of published reports on this topic. While more evidence will always be welcome, this time the group was able to produce several recommendations based on available data. According to the manuscript, “The purpose of this study was to refresh the body of knowledge and evaluate the current evidence for the effectiveness of rapid diagnostic practices to decrease the time to targeted therapy (TTT) and improve outcomes for hospitalized patients with BSIs.” They define rapid diagnostics as those that take about 2 hours or fewer to return results.

Key Recommendations: Rapid Testing and Communication Are Critical

Of the eight total recommendations included in the report, five are classified as strong or moderate. In short, the panel recommends the implementation of rapid diagnostic tests for patients with positive blood culture results, combined with an active communications strategy for sharing actionable reports with clinical colleagues. According to the evidence reviewed, this approach would help get patients on targeted therapies faster, shorten hospital stay durations for ICU and other patients, reduce longer stays caused by infection complications, and possibly decrease the 30-day mortality rates for patients with bloodstream infections. Molecular tests such as nucleic acid amplification tests are covered under the groups of rapid diagnostic tools recommended.

Why Communication Strategies Matter in Diagnostic Stewardship

The panel’s focus on a communication strategy was noteworthy. Throughout the recommendations, the laboratories make it clear that using rapid diagnostics without a clear plan to communicate results with appropriate clinical counterparts was not sufficient to change outcomes for patients. This might seem obvious, but in the case of bloodstream infections, timeliness is essential. Without a clear method for quickly sharing clinical information with the right people, the results of any diagnostic tool—even the fastest of tests—could be received too late to make a difference in patient care.

Diasorin’s Commitment to Rapid Bloodstream Infection Testing

At Diasorin, we understand how important it is to generate fast, reliable results for patients suffering from bloodstream infections. These are serious conditions associated with high rates of morbidity and mortality, which is why we have offered rapid diagnostic tests in this area for years. Our newest product line for bloodstream infection testing was designed for the LIAISON PLEX® System, a sample-to-answer device for multiplex molecular diagnostic testing. We offer three FDA-cleared tests to help clinical laboratories comply with diagnostic stewardship goals: the LIAISON PLEX® Gram-Positive Blood Culture Assay, the LIAISON PLEX® Gram-Negative Blood Culture Assay, and the LIAISON PLEX® Yeast Blood Culture Assay. Each test is intended for use after Gram staining, with those results informing which diagnostic test is appropriate for each patient. By pairing our tests with the standard Gram staining process, we’re also ensuring that they fit neatly into existing laboratory workflows for seamless implementation.

To learn more about bloodstream infection testing options from Diasorin, click here.

From Fixed to Flexible Syndromic (Flex™) Testing: Lessons from Norton et al. on Advancing Respiratory Diagnostics

By Diasorin Product Management

“The flexibility in designing respiratory viral (and bacterial) testing tiers is expected to save staff time and reagent costs while increasing the clinical diagnostic yield.” — Norton et. al., Journal of Clinical Microbiology, June 2025 

In a time of rising costs and staffing shortages, clinical labs need smarter, more efficient diagnostics. The June 2025 Journal of Clinical Microbiology study by Norton et al.1 offers a compelling case for moving from traditional fixed syndromic panels to flexible syndromic testing using the LIAISON PLEX® Respiratory Flex Assay (RSP Flex).

Why flexible syndromic testing matters

Many suppliers offer fixed panel systems that do not allow for target customization or flexible pricing. These systems require labs to test—and pay for—the full panel, regardless of clinical need. Additionally, they are often utilized as reflex testing after initial influenza, RSV, and SARS-CoV-2 testing, repeating steps that consume staff time and force patients to pay twice for redundant results.

In contrast, the LIAISON PLEX RSP Flex allows on-the-fly custom panel creation and flexible pricing all on a single instrument, and labs pay only for reported results. Furthermore, if the initial panel is negative, additional results can be instantly released from the same initial test run, and no additional sample processing is required. Norton et al. evaluated the LIAISON PLEX RSP Flex against a standard two-step, fixed panel algorithm, showing that the test offers equivalent performance with far greater efficiency and customization.

Key findings from the study

  • High Accuracy: The LIAISON PLEX RSP Flex demonstrated 90% positive, and 98% negative agreement compared to the cobas® eplex Respiratory Pathogen Panel 2. Additionally, BioFire® Respiratory 2.1 agreed with the LIAISON PLEX RSP Flex for 3 out of the 5 discrepant results.
  • Improved Diagnostic Yield: Adding enterovirus/rhinovirus to a core panel can improve yield from 12.5% to nearly 26%.
  • Simple Customization: The LIAISON PLEX RSP Flex makes adding relevant targets (like enterovirus/rhinovirus) easy, unlike fixed panels, which cannot be customized.
  • Operational Efficiency: Using the LIAISON PLEX RSP Flex could eliminate over 92 hours (5,545 minutes) of staff time per respiratory season by avoiding repeat testing and second swabs.
  • Cost Control: The LIAISON PLEX RSP Flex helps reduce waste by enabling targeted testing based on seasonal trends and clinical presentation (i.e., only pay for what you report).
    • In a peer-reviewed study, it was demonstrated that including the five most prevalent targets can capture >76% of all positive results.2

Diagnostic stewardship in action

The LIAISON PLEX RSP Flex empowers labs to begin with a streamlined panel of up to seven targets and instantaneously expand testing only when clinically necessary—no retesting, no double billing, and no waste. This flexibility enhances patient care while aligning with diagnostic stewardship goals.

Ready to Step Away from “All-or-Nothing” Panels?

The Norton et al. study concludes that the LIAISON PLEX RSP Flex matches the performance of fixed panels while offering customizable panels, reduced labor, and improved diagnostic outcomes. No longer locked into overbuilt panels or forced to reflex test to uncover the root cause of infection, you can instead align testing with local pathogen trends and clinical needs while reducing costs by only paying for what you choose to report.

In a healthcare environment demanding more with less, the LIAISON PLEX RSP Flex is not just a feature—it’s a strategic advantage.

Get the details—read the paper now.

 

Citations:

  1. Norton JM, Dashler G, Klein E, Mostafa HH. The utility of syndromic respiratory pathogen panels: the premise of flexible and customizable approaches. J Clin Microbiol. 2025;0(0):e00313-25. doi:1128/jcm.00313-25.
  2. Gonzalez K., Amicarelli G. Age-Stratified Epidemiology of Respiratory Pathogens and the Value of Customizable Syndromic Testing Using the LIAISON PLEX Respiratory Flex Assay. J Mol Diagn. 2025 Jun 26:S1525-1578(25)00142-4. doi: 10.1016/j.jmoldx.2025.05.009.

New Podcast: “Beyond the Result” Spotlights the Benefits of Diagnostic Stewardship

By Stephanie Ibbotson and Molly Frazier

The first two episodes feature clinical lab veterans who share practical tips about how to launch a successful stewardship program

There’s no question that laboratory medicine has a tremendous impact across healthcare, which is why diagnostic stewardship efforts have been shown potential to improve patient care, increase efficiency in the healthcare setting, and reduce overall costs. Recently, we launched a new podcast to highlight the value of diagnostic stewardship programs. “Beyond the Result: Customizing Infectious Disease Diagnostics for Better Care” hosted by our own Angelo Rago, features conversations with leaders in laboratory medicine who have experienced perspectives on diagnostic stewardship.

His first guest was Dr. James Snyder, a professor in the Department of Pathology and Laboratory Medicine and Chief of Microbiology at the University of Louisville Hospital. Dr. Snyder set the stage with two statistics: laboratory testing accounts for less than 5% of total healthcare expenditure in the US, yet lab results influence 70% of all medical decisions. With so much impact across healthcare, laboratory teams are feeling tremendous pressure to maximize their resources and to use every resource responsibly.

Dr. James Snyder on building an effective stewardship program

Dr. Snyder mentioned that he takes advantage of every opportunity to educate his colleagues about the lab, the tests offered, and how his team can help support clinical decision-making. This has been important for advancing his team’s diagnostic stewardship program, which was launched more than six years ago. For anyone interested in implementing a similar program, he offered practical advice: first, form a multidisciplinary committee with members from as many relevant specialties as possible (his includes surgeons, internists, pharmacists, and infection control experts, in addition to the laboratory members). Second, find a champion on the hospital leadership team to ensure a long-term commitment. And third, check out helpful recommendations from the Clinical and Laboratory Standards Institute designed for this exact purpose.

Hear this and more from Dr. Snyder on Beyond the Result Episode 1: The Diagnostic Stewardship Revolution

Dr. Nathan Ledeboer on data-driven stewardship and executive support 

In our second podcast episode, Angelo spoke with Dr. Nathan Ledeboer, Medical Director of Clinical Microbiology and Molecular Diagnostics at the Medical College of Wisconsin. Dr. Ledeboer has a history of implementing diagnostic stewardship, applying it in various ways for 20 years. In the early days, he said the process involved painstaking manual review of test ordering patterns to identify opportunities for improvement. However, his team has since shifted to a more prospective approach paired with clinical decision support tools to help clinicians choose the most appropriate test for each situation.

At the Medical College of Wisconsin, that shift was enabled by initiatives designed to address financial pressures caused by the COVID-19 pandemic. With the institution’s executive team looking to expand stewardship programs across many departments to improve efficiency, there was high-level attention on diagnostic stewardship. That kind of leadership buy-in, Dr. Ledeboer said, opened the doors for access to resources and support that advanced the diagnostic stewardship efforts. This included having an analyst who could mine much more information from the electronic medical record system, moving diagnostic stewardship into “turbo charge mode,” he said.

Hear this and more from Dr. Ledeboer on Beyond the Result Episode 2: Precision Without Waste

Paving the way for diagnostic stewardship, one success at a time

In his advice for other clinical lab teams, Dr. Ledeboer noted the importance of having early successes. In his case, a pilot project for a costly send-out test used by the neurology department led to a decision support tool that points clinicians to the most appropriate test, which improved the use of recommended testing and saved hundreds of thousands of dollars, Dr. Ledeboer said. It also generated enthusiasm throughout the healthcare system and showed the potential for how diagnostic stewardship could make a difference. Subsequent projects involved fecal testing, tickborne disease testing, and CNS testing. “Find areas where you have good clinician support, obvious patient benefit, and good potential for cost savings,” he recommended.

Future episodes of the Beyond the Result podcast will continue these important themes, with guests including

  • Mark Zaydman, ​assistant professor of pathology and immunology in the Division of Laboratory and Genomic Medicine of Washington University in St. Louis
  • Margie Morgan, PhD, director of clinical microbiology at Cedars-Sinai in Los Angeles

Whether you’re a healthcare executive, decision-maker, or laboratorian, “Beyond the Result” is your front-row seat to the future of diagnostics—because better diagnostics means better care.

Sign up to be notified when new episodes become available!

“Smarter Diagnostics” with a Flex™ Respiratory Testing Approach

By Diasorin

At Holland Hospital, the clinical lab team achieved more appropriate testing, along with six-figure cost savings, by implementing a customizable assay for respiratory infections

At the annual meeting of the Pan American Society for Clinical Virology (PASCV) earlier this year, there was a very informative presentation from Nicholas Decker, Director of Laboratory Services at Holland Hospital in Michigan, about his experience implementing a Flex™ Testing approach for respiratory infections. The talk offered useful highlights for clinical laboratory professionals wondering whether this model would make a difference in their healthcare systems. We’ve summarized the key points here, but the entire presentation is well worth watching.

A Challenging Landscape

A more flexible testing option is needed due to growing challenges facing most clinical laboratories. Decker pointed to rising costs, reimbursement issues, and staff shortages as common pain points—and noted that even amid all these other problems, his lab’s test menu, testing volume, and testing complexity have all been increasing. “We need solutions now, and not in five years,” he said. “We have to become more responsible with our resources.”

Another challenge has been the widespread use of broad syndromic testing panels, which are often employed even when a large panel is not clinically appropriate. Overutilization of these panels has driven up costs and made it harder to implement effective diagnostic stewardship practices.

What is Flex Testing?

Diasorin offers the unique Flex Testing model to help clinical teams address these issues. It delivers the best of both worlds: the test covers the same diversity of pathogens as a broad syndromic panel, but users get to choose which targets to report, and they pay only for the results reported out. This allows laboratories to create custom mini panels from subsets of targets on the larger panel, leading to more appropriate testing and reducing overall costs. But in cases where the full list of targets is warranted, all results are available and ready to report in the same rapid turnaround time.

At Holland Hospital, Decker and his team were early adopters of the FDA-cleared LIAISON PLEX® Respiratory Flex Assay, which includes a total of 19 bacterial and viral targets associated with respiratory infections. “I have yet to find a case where this didn’t help us out,” he told meeting attendees. The ability to create custom mini panels is helpful for responding to local epidemiological changes, the flux of seasonality, and shifting reimbursement coverage.

In addition to the benefits of a flexible testing model, he also pointed to other beneficial attributes of the assay: room temperature storage, scalability, random access testing, a sample-to-answer workflow, and a handy touchscreen interface.

Holland’s Approach: Impressive Savings

In Decker’s lab, the team was eager to use a more customizable option—but also wary of creating a more difficult or complicated protocol. “We want to take care of all of our patients using the same process, the same workflow,” he said.

With that in mind, the team stratified their patient population into two broad categories: inpatients, for whom the cost of each test is less important due to diagnosis related group (DRG) usage and who tend to be sick enough to require a large syndromic panel; and outpatients, for whom test prices play a significant role and are generally less acutely ill and more likely to benefit from targeted testing.

Decker’s lab began Flex Testing last fall, with ambitious goals for how much money the customizable assay would save over time. “We projected six figures’ worth of financial improvement to the bottom line just by containing the overuse of 20-plus target panels,” he said at the conference. “I’m proud to share that we not only achieved that—we yielded a 10% higher return than we even budgeted.”

The laboratory team defined mini panels both by clinical utility and reimbursement considerations, leveraging guidance from a white paper, now published as a peer-reviewed article by Gonzalez et al., 2025 in The Journal of Molecular Diagnostics (JMD). Decker also stressed the importance of planning ahead; his team wanted the ability to redesign panels as needs change over time, so they worked carefully within their LIS to make sure that would be possible. They honed algorithms to ensure that it was clear to everyone when to reflex to the full syndromic panel if all targets on a mini panel returned negative results.

“Customizable testing supports smarter diagnostics,” Decker concluded. “Smarter diagnostics makes us all look better.”

Learn more about the LIAISON PLEX Respiratory Flex Assay.