Managing physician use of laboratory tests

Area of Science:

• Clinical Laboratory Management
• Healthcare Economics

Background:

• Financial pressures from managed care and capitated reimbursement necessitate cost-control strategies in clinical laboratories.
• Laboratories are already implementing measures to reduce the unit cost of testing.

Purpose of the Study:

• To evaluate the effectiveness of active management of laboratory test utilization as a strategy to address financial pressures.
• To identify key considerations and successful approaches for laboratory utilization management.

Main Methods:

• Review of literature on laboratory utilization management strategies.
• Analysis of factors influencing the success and limitations of different approaches.

Main Results:

• Active management can yield savings that exceed the costs of a utilization management program.
• Effective utilization management requires understanding measurement, benchmarks, and inherent constraints.
• Educational approaches have historically shown poor results in reducing utilization.

Conclusions:

• Active management of laboratory test utilization is a practical and potentially cost-effective approach.
• Financial feedback and environmental modifications for test ordering show promise for improving utilization.
• Successful implementation necessitates awareness of measurement, benchmarks, and psychological/structural barriers.