Blog Ordered Points

 In a blog about a CMS meeting, I noted that experts had opined on 9 points.   I gave Chat GPT the 9 points in my own typing, but asked Chat GPT to reorder the points.

Here's how it answered when I asked "WHY" it had done so.

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Sure! Here's a detailed explanation of how I made the decisions to reorder the points logically:

1. The public comment presentations in June are very helpful – it’s frustrating that “half” of codes lack a presentation in that forum.

   • This sets the stage by highlighting a major issue: the lack of presentations for half of the codes, which impacts the panel's ability to make informed decisions.

2. Companies present elaborate and useful info packets to AMA, but they dead-end there and are not part of the crosswalk process. Could the companies/AMA/CMS facilitate sharing, at least as an option?

   • Following the initial point, this highlights a related issue: the detailed information packets that are not shared with CMS, suggesting a potential area for improvement.

3. The panelists would like to have patient result reports for each test.

   • Building on the need for more information, this point specifies a particular type of useful information that the panelists need.

4. Inclusion of an FDA instructions for use would help.

   • This continues the theme of needing more detailed information, specifically mentioning FDA instructions as another helpful resource.

5. One frustrating scenario is when a test in one year (000XU) is sent to gapfill, and the next summer a very similar code is created (00XXU). The new code can’t be crosswalked to 000XU, but it’s a similar code and for consistency the price should be the same. Under today’s rules, 00XXU will get sent to gapfill in the next year, a waste of gapfill resources and potentially a source of price inconsistency.

   • This point transitions to specific procedural issues, illustrating a scenario where the current rules lead to inefficiencies and inconsistencies.

6. It seems unfair to price two tests differently, one with 10 markers, one with 20, when they output the same result with the same accuracy.

   • Continuing with procedural issues, this highlights a fairness concern in pricing, which builds on the previous point about consistency.

7. There was discussion that the PLA codebook has no structure, and with >500 codes, that’s confusing and makes crosswalk searches unreliable.

   • This point addresses the structural issues in the PLA codebook, adding to the theme of procedural and organizational challenges.

8. What does “appropriate crosswalk” mean? Intended use? Method? Number of analytes? CMS noted that both creating such rules – and the lack of the rules – is problematic.

   • This follows logically from the previous point by questioning the criteria for crosswalking, a core issue in the pricing process.

9. When public stakeholders align on a pricing proposal, that’s impressive and helpful.

   • Ending on a positive note, this acknowledges the benefits of stakeholder alignment, suggesting that collaboration and agreement can lead to successful outcomes.

The reordered points follow a logical flow from identifying the problem, detailing specific issues and needs, discussing procedural challenges, and concluding with a note on potential solutions and positive aspects.