Volume 40 Number 3 | June 2026
Summary

This article explores the future of laboratory advocacy, highlighting ongoing challenges like reimbursement and workforce shortages, emerging roles for laboratorians as diagnostic consultants, and potential impacts of innovation. It emphasizes that active advocacy, education, and engagement are essential for shaping policies and protecting patient care.

Debbie Shell, MS, MLS(ASCP)CM SM,DLM, ASCLS Government Affairs Committee Member

Debbie ShellHealthcare in America is a heavily regulated industry, with numerous laws and regulations demanding compliance. In the clinical laboratory, we have all experienced the training sessions, inspections, and procedures necessary to comply. As we look to the future of our profession and our industry with respect to new laws and regulations, a crystal ball would certainly be helpful!

There are many lab-related issues that ASCLS has been heavily involved in for years, if not decades. When updating members about the Labvocacy we have pursued, I am often surprised about when the journey began for each issue:

  • Reimbursement (at least 40 years ago)
  • Workforce shortages (more than 25 years ago)
  • Laboratory developed tests (more than 15 years ago)
  • CLIA personnel standards (since the 1990s)

ASCLS has a great track record with advocacy on these and many other issues impacting clinical laboratories and the professionals that work in them. In fact, some of our partner organizations credit ASCLS for doing a lot of the “heavy lifting” in advocacy activities. That’s a tradition we hope to maintain!

But where will we head in the future? What types of legislation and regulation can we predict are just around the corner?

Reimbursement

Reimbursement for patient testing is often at the top of the list of concerns in the laboratory. Without adequate payment for tests performed, laboratories cannot bring on new tests, hire sufficient staff, or replace outdated equipment, all of which are necessary for a high-quality patient experience. ASCLS and our partners have been diligent for many years in proposing a variety of solutions to inadequate reimbursement, and in educating legislators about the impacts of inadequate reimbursement on patients.

Currently, ASCLS and many collaborators are promoting the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services Act (RESULTS Act) (S.2761)/H.R.5269) to legislate a permanent and equitable solution to inadequate reimbursement for Medicare patient testing. Without this legislation, it is possible that laboratories will face ongoing decreased reimbursement, restricted test menus, fewer (and possibly less qualified) staff members, and possible closure of some laboratories.

What does our crystal ball say about this or other future legislation to solve the problem? This legislation has broad industry support, and excellent testimony was given in January at a House Energy and Commerce Committee hearing. If this bill can save Medicare some money, it has a chance to pass. If not, the outlook is likely dim.

Workforce Shortages

Another issue of concern to laboratorians, and likely the one affecting them most directly, is a workforce shortage. Does our crystal ball predict any hope for resolving this long-time issue that not only plagues laboratory professionals, but also other healthcare professions? For more than 25 years, collaborations of laboratory associations, federal agencies, colleges and universities, and industry partners have attempted to determine the cause for laboratory personnel shortages, propose solutions, and implement as many of those solutions as possible. And yet, shortages persist, becoming even worse during the COVID years.

ASCLS continues to pursue both legislative and administrative fixes. ASCLS Legislative Consultant Patrick Cooney has drafted the Medical Laboratory Personnel Shortage Relief Act (HR5444) and has obtained bipartisan support with sponsors Jen Kiggans (R-VA) and Deborah Ross (D-NC). Again, we anticipate a large coalition of organizations, including Association for Diagnostics & Laboratory Medicine (ADLM), American Medical Technologists (AMT), National Accrediting Agency for Clinical Laboratory Sciences (NAACLS), Board of Certification (BOC) and Association of Medical Laboratory Education Programs (AMLEP) to join us in the effort to get this legislation passed.

A proposed Congressional briefing is planned for June 3, 2026, in support of this legislation. Educating legislators on the impact of laboratory workforce shortages is a key step in getting this legislation passed. The crystal ball sees small, incremental changes in educational funding as a possibility, but legislation has a more difficult path.

Diagnostic Consultants

I believe (and hope) another future accomplishment will be that laboratorians move from being primarily data generators to diagnostic consultants. We are moving in that direction with more Doctor of Clinical Laboratory Science (DCLS) degreed professionals among our ranks. But I also believe that it is incumbent on each of us to also serve in this capacity, even without a DCLS degree. Who better to interact with and educate our healthcare colleagues about laboratory testing than our well-educated and trained laboratory professionals?

We need to come out from behind the laboratory doors to interact with and assist physicians and nurses, not just about the interpretation of laboratory tests and their appropriate utilization, but to have a true impact on patient care. Value-based care is a concept gaining traction in many facilities. I’m unsure what types of legislation or regulation may control this consultant role; we’re pleased that CLIA accepts the DCLS as laboratory director for non-waived laboratories, thanks to Labvocacy from ASCLS members and others in the profession. The crystal ball says this may happen slowly over time, as more hospitals adopt initiatives for value-based care.

More Questions

There are many other issues that may come to the forefront in the future, some of them issues we have worked on before (e.g., regulation of laboratory-developed tests, CMS personnel standards), and others that we may not anticipate.

  • How will artificial intelligence (AI) affect not just clinical laboratories, but healthcare in general?
  • How will new biomarkers, genomic sequencing, and other discoveries impact not just the tests we perform, but also laboratory workflow?
  • Will chat-bots be able to replace the dream of laboratorians being recognized as diagnostic consultants, giving physicians and others 24-hour access to answers for test interpretation and follow-up orders.
  • Will non-invasive, sensor-based test techniques using infrared light or radio waves become so prevalent that many laboratory tests will no longer be performed in the laboratory?
  • Will Star Trek’s tricorder become reality?
  • And, how well regulated will all these new innovations be?

We’ve already seen a large migration of testing now performed outside the laboratory and by non-laboratorians in the form of point-of-care tests, and that migration is not likely to end any time soon. Could a full body scan for the standard CMP, cardiac panel, and CBC order become a reality? The crystal ball says many of these advances will take place, but it’s unclear how they will be regulated!

How to Take Action

As with many aspects of life, predicting the future is difficult, if not impossible. One important aspect is how we react to what’s coming. Do we have the power to shape the future? More importantly, do we have the will to try to shape the future? There are many actions we can take:

  • Maintain membership in ASCLS and recruit new members; every professional needs an organization that will advocate on their behalf. And, that organization needs a large, supportive membership base.
  • Keep up to date on the legislative and regulatory issues facing the profession by attending updates and webinars, and by reading newsletters and other communications. Share this information with work colleagues who may not keep up to date or realize what issues laboratories are facing. Labvocate.org is an excellent source of information on issues, lobbying, and how to take action.
  • Communicate with legislators and regulatory agencies and ask for their support whenever an issue requires action; ASCLS communicates these needs with Action Alerts sent to all members. Respond to all Action Alerts as requested. With this system, a well-written request can be sent to your senators and representatives with just a few minutes of your time.
  • Become a “Labvocate” by volunteering to serve on your constituent society Government Affairs Committee or the ASCLS Government Affairs Committee. Volunteer to become an ASCLS Labvocate Ambassador. Offer to update the members of your constituent society on legislative and regulatory affairs by presenting updates at membership and Board of Directors meetings. Write an article for your constituent society newsletter.
  • Advocate for medical laboratory science with work colleagues; with hospital administration; with educational institutions from K-12 through colleges and universities; and with family, friends, and neighbors. Everyone needs to understand the importance and value of well-educated and trained laboratory professionals. Patient care will suffer without them.

Although the future may be impossible to predict, when we work together with our colleagues across the laboratory community, we can have an influence on the direction of legislation and regulations. In fact, we must be that influence. Without our collective efforts, the future for laboratories will be shaped by those who don’t know our profession and its impact on patient care but rather look at immediate financial cuts as the answer, not considering the long-term effects of a dollar-saving only approach. We must continuously advocate for our profession and for our patients.

Debbie Shell is a Laboratory Instructor at Idaho State University in Pocatello, Idaho.