Abstract
Utilization management requires significant effort and time for clinical laboratory directors. The goal of utilization management is to reduce the cost of care without reducing the quality. Laboratory directors must effectively communicate to hospital administration evidence-based utilization plans designed to reduce costs. This requires more than simply calculating the expense impacts associated with changes in test utilization. It is essential to fully document the link between utilization optimization and more cost-effective clinical operations. This chapter discusses methods for calculating costs and savings associated with utilization management of laboratory testing in academic hospitals. Approaches to estimating the impact of utilization changes on healthcare outcomes are also discussed and emphasized as becoming critical in the near future.
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References
Gass Kandilov AM, Pope GC, Kautter J, Healy D. The national market for Medicare clinical laboratory testing: implications for payment reform. Medicare Medicaid Res Rev. 2012;2:1–21.
Branda JA, Dighe AS, Dzik W, et al. The practice of clinical pathology: a quantitative description of laboratory director activities at a large academic medical center. Am J Clin Pathol. 2014;142:144–9.
Young DS, Bekeris LG. The inordinate complexity of delivering laboratory services in the USA. Ann Clin Biochem. 1999;36(Pt 2):123–32.
Price CP, St John A. Innovation in healthcare. The challenge for laboratory medicine. Clin Chim Acta. 2014;427:71–8.
Travers EM, McClatchey KD. Basic laboratory management. In: McClatchey KD, editor. Clinical laboratory medicine. 2nd ed. Philadelphia, PA: Lippincott Williams & Williams; 2015. p. 3–49.
MacMillan D. Calculating cost savings in utilization management. Clin Chim Acta. 2014;427:123–6.
Buchner DS, Hynes WM. Cost accounting in the clinical laboratory. In: Lewandrowski K, editor. Clinical chemistry: laboratory management and clinical correlations. 1st ed. Philadelphia, PA: Lippincott, Williams & Williams; 2002. p. 70–80.
NCCLS. Basic cost accounting for clinical services: approved guideline. Wayne, PA: NCCLS; 1998.
Travers EM. Laboratory manager’s financial handbook. Cost accounting: the road map to financial success. Clin Lab Manage Rev. 1996;10:265–85.
Lewandrowski K. Managing utilization of new diagnostic tests. Clin Leadersh Manag Rev. 2003;17:318–24.
Miller CE, Krautscheid P, Baldwin EE, et al. Genetic counselor review of genetic test orders in a reference laboratory reduces unnecessary testing. Am J Med Genet A. 2014;164A:1094–101.
Shirts BH, Jackson BR, Baird GS, et al. Clinical laboratory analytics: challenges and promise for an emerging discipline. J Pathol Inform. 2015;6:9.
Zhong Y, Lin PJ, Cohen JT, Winn AN, Neumann PJ. Cost-utility analyses in diabetes: a systematic review and implications from real-world evidence. Value Health. 2015;18:308–14.
Komenda P, Ferguson TW, Macdonald K, et al. Cost-effectiveness of primary screening for CKD: a systematic review. Am J Kidney Dis. 2014;63:789–97.
Fang C, Otero HJ, Greenberg D, Neumann PJ. Cost-utility analyses of diagnostic laboratory tests: a systematic review. Value Health. 2011;14:1010–8.
Westwood M, van Asselt T, Ramaekers B, et al. KRAS mutation testing of tumours in adults with metastatic colorectal cancer: a systematic review and cost-effectiveness analysis. Health Technol Assess. 2014;18:1–132.
https://www.optum.com/solutions/data-analytics.html. Downloaded 13 Sept 2016.
Attali M, Barel Y, Somin M, et al. A cost-effective method for reducing the volume of laboratory tests in a university-associated teaching hospital. Mt Sinai J Med. 2006;73:787–94.
Baron JM, Lewandrowski E, Januzzi JL, Bajwa EK, Thompson BT, Lewandrowski KB. Measurement of high-sensitivity troponin T in noncardiac medical intensive care unit patients. Correlation to mortality and length of stay. Am J Clin Pathol. 2014;141:488–93.
Lamy A, Tong WR, Bainey K, Gafni A, Rao-Melacini P, Mehta SR. Cost implication of an early invasive strategy on weekdays and weekends in patients with acute coronary syndromes. Can J Cardiol. 2015;31:314–9.
Ishak KJ, Stolar M, Hu MY, et al. Accounting for the relationship between per diem cost and LOS when estimating hospitalization costs. BMC Health Serv Res. 2012;12:439.
Snider M, Carnes C, Grover J, Davis R, Kalbfleisch S. Cost-benefit and cost-savings analyses of antiarrhythmic medication monitoring. Am J Health Syst Pharm. 2012;69:1569–73.
Szczepura, A. Routine low-cost pathology tests: measuring the value in use of bacteriology tests in hospital and primary care. Health Serv Manage Res. 1992;5:225–237.
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Sluss, P.M. (2017). Calculating Costs and Savings in Utilization Management. In: Lewandrowski, K., Sluss, P. (eds) Utilization Management in the Clinical Laboratory and Other Ancillary Services. Springer, Cham. https://doi.org/10.1007/978-3-319-34199-6_6
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DOI: https://doi.org/10.1007/978-3-319-34199-6_6
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