Calculating costs and savings in utilization management

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.