Reducing the inappropriate utilization of clinical laboratory tests

Reimbursement policies for health-care services in Connecticut and the U.S. have gradually shifted towards fixed reimbursements through implementation of managed care. As a result, there is an increasing need by physicians and other care givers to reduce costs without compromising the quality of the care being delivered. The clinical laboratory is one area where significant cost reductions may be realized. More effective utilization can be accomplished with the elimination of panels of tests, such as the general chemistry profile, removal of antiquated tests or those that provide redundant information, judicious use of drug assays, acceptance of clinical practice guidelines, and use of reflex testing algorithms. Physicians should also focus more on prognostic indicators for disease prevention. Point-of-care testing devices which have higher costs than incremental central laboratory expenses should be used only if it reduces overall operating expenses, as assessed by outcomes analyses. New technologies such as DNA probes can substantially improve diagnostic efficiency. Physicians and clinical laboratories must collaborate to achieve more efficient utilization practices.