Managing physician use of laboratory tests.
The active management of laboratory test utilization appears to be a practical approach to addressing the financial pressures imposed by managed care and capitated reimbursement, and can complement efforts already underway in most laboratories to reduce the unit cost of testing. Managing laboratory utilization takes time that is often in short supply; however, the literature suggests that the savings from a well-focused effort can easily exceed the costs of a utilization management program. Individuals and institutions that commit themselves to active utilization management need to realize (1) how laboratory utilization is measured, (2) benchmarks within the industry, and (3) the stubborn structural and psychological constraints that are likely to limit progress. Some approaches to reducing utilization, such as education, have poor track records and are best avoided. Other avenues, such as providing financial feedback and making specific changes to the environment in which tests are ordered, have demonstrated moderate success in the past and hold considerably more promise.
Valenstein
P
P
Department of Pathology St. Joseph Mercy Hospital, Ann Arbor, Michigan, USA.
D019411:Clinical Laboratory Techniques / Q000706:statistics & numerical data*; D003365:Costs and Cost Analysis; D005246:Feedback; D006302:Health Services Research; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011787:Quality of Health Care; D014481:United States