OPERATIONS - MANAGING THE UTILIZATION OF DIAGNOSTIC TESTS: DEVELOPING A LABORATORY UTILIZATION MANAGEMENT PROGRAM

Course overview

New approaches to physician reimbursement will require pathologists to redefine their role as leaders in hospital-based healthcare organizations. Accountable care organizations will emphasize cost effective high quality care in which fee for service is replaced by a global payment for an episode of care. Practicing pathologists will be required to assume new professional roles that demonstrate the value of pathologists within the health care system. Utilization management is one such role in which pathologists equipped with the appropriate knowledge and skills can become leaders in the design of new models of care. Current and future models for reimbursement of health care will increasingly focus on controlling unnecessary utilization while improving the overall quality of care. Many studies have described individual initiatives to control the utilization of one or a few tests. However, there is little published experience with establishing an ongoing utilization management program (UMP).