Establishing benchmarks and metrics for utilization management.

Area of Science:

• Clinical Laboratory Science
• Healthcare Management
• Health Services Research

Background:

• Healthcare reimbursement models are evolving, increasing the importance of laboratory utilization management.
• Benchmarking is a standard practice for assessing clinical laboratory operations and performance.
• Existing resources for benchmarking laboratory utilization management are limited.

Purpose of the Study:

• To review the current literature and available services for laboratory utilization management benchmarking.
• To provide guidance for clinical laboratories seeking to manage physician test requests through benchmarking.

Main Methods:

• Literature review of existing studies and services related to laboratory benchmarking and utilization management.
• Analysis of resources applicable to managing physician laboratory test orders.

Main Results:

• Established benchmarking practices exist for general laboratory operations but are less developed for utilization management.
• A gap exists in readily available resources specifically for laboratory utilization management benchmarking.

Conclusions:

• There is a critical need for enhanced benchmarking tools and strategies for laboratory utilization management.
• Clinical laboratories must adapt to new reimbursement environments by optimizing test utilization.