Healthcare waste makes up a massive 34% of total $3.2 trillion spent on healthcare in the United States.1 Nearly half of this arises from unnecessary expenses such as excessive imaging and laboratory tests. By paying for value, much of this clinically unwarranted waste can be eliminated.
Laboratory and pathology testing accounts for 4% of total annual healthcare costs (over $60 billion) with an annual increase of 15% to 25%. Additionally, Medicare spending on all Part B laboratory services increased by 29%.2 This increase is significantly disproportionate to the average 10% increase in enrollment in Medicare Part B.2 A substantial volume (~42%) of laboratory testing can be regarded as a wasteful spending. Commonly ordered tests such as CBC and urinalysis are often cited as being overused, and redundant testing alone accounts for $8 billion annually.3 Reduction in unnecessary lab tests by establishing acceptance criteria and ensuring adherence is one approach to both reduce costs and improve quality of patient care.
Lab tests should be ordered with the goal of providing high-quality and cost-effective care after evaluating the clinical necessity of the test and with improved patient care as the primary driving force.
Redundant testing, one of the primary causes of inappropriate utilization, occurs when tests are ordered by multiple clinicians for a given patient. Such unnecessary tests crop up when repetitive orders are placed without periodic assessment of clinical necessity. Furthermore unnecessary tests also happen when orders are repeated within a time span that is too short to detect any clinically relevant change. Ordering the wrong test is not only wasteful but also potentially harmful to patients. High frequency of blood draws can be disruptive and lead to interruption of normal sleep patterns for inpatients. In intense cases, frequent blood draws can also lead to hospital-acquired anemia. Lab test overutilization can also lead to an increase in false-positive results that again drive other inappropriate lab or defensive diagnostic testing. Furthermore, unnecessary testing can divert nursing and phlebotomy teams from their core tasks. Inadequate education and awareness of standards at the point of care for physicians can be attributed to such inappropriate lab service utilization. Patient preparation is equally important and challenging as it includes factors (diet and posture/exercise) that may lead to variation in results. The patient needs to be informed regarding the risk associated with such factors before arriving for sample collection.
There are three steps involved to effectively curtail a significant number of these unwarranted tests and help providers use lab testing more efficiently:
(1) A data-driven approach to isolate lab services, benchmark physicians, examine the variability of lab test utilization, and present the data to understand the source of care variation.
(2) Physician education campaigns emphasizing the degree of overuse of lab services and its potential for harm to create a roadblock to repetitive ordering and inappropriate ordering behavior. Develop talking points for physicians to discuss with patients and create online resources to house the tools and content.
(3) Efficient patient education interventions by disseminating patient education materials to address patient demands.
Optimizing lab service utilization involves numerous interventions that encompass ordering and monitoring combined with influencing patient preparation to get the best results. A data-driven approach to understand the test patterns and deviations from guidelines and actively engage physicians with relevant clinical content is necessary to reduce unnecessary lab utilization and generate cost savings.
Learn how we can help to understand your total cost of care using your cost and clinical data, unearth the improvement opportunities, engage your physicians, and deliver practice change. We look forward to opportunities to apply Variation IQ tools and processes to enhance the healthcare of your patients, while improving your operational efficiency and margins.
1. Berwick DM, Hackbarth AD. Eliminating waste in US health care. JAMA. 2012;307(14):1513-1516. doi:10.1001/jama.2012.362
2. Murrin S. Questionable billing for Medicare Part B clinical laboratory services. Department of Health and Human Services. 2014. https://oig.hhs.gov/oei/reports/oei-03-11-00730.asp Accessed September 24, 2014.
3. Improving safety and eliminating redundant tests: cutting costs in U.S. hospitals. (http://content.healthaffairs.org/content/28/5/1475.full )
Any personal information provided by Indegene users will be maintained under strict confidentiality. We will not sell, disclose, or distribute personally identifiable information to any other entity unless the user is first notified and expressly agreed to it. Notwithstanding the above, we may indeed disclose personal information if required to do so by or as otherwise required by law. We want you to feel comfortable and have the confidence that we will make every effort to protect your confidentiality.
All the information provided by Indegene on its websites including but not restricted to images, facts, content, graphs, etc are the confidential and proprietary information of Indegene.
We have installed a number of security measures to protect the confidentiality of your personal information. We will be constantly upgrading our security system to keep in line with changing requirements. Some of the features used by indegene.com are given below:
We have a firewall to prevent unauthorized access to our systems.
Your membership information lives on a separate database server that sits behind this firewall. We safeguard your mail information with an encryption technology called Secure Socket Layer (SSL).
Indegene has developed a registration/login process so that your personal profile is password protected. You are the only one who has access to your personal information. You should always log out when you're done with your session to ensure that others cannot access your account. This becomes more so applicable when you are accessing your account on terminals other than your personal PC.
An Internet Protocol address is a unique string of numbers assigned to your computer by your Internet Service Provider (ISP). All computers must have an IP address in order to connect to the Internet. This address may be the same every time you log on or a different number may be assigned each time you connect. Indegene may use your IP address in an effort to determine the quickest route for your computer to use when connecting to our site's servers. User IP addresses are used by our Web server logs to count the number of users who visit different pages. We do not use this IP information in any other system.
Indegene information has been divided into two major categories. Some of the information is freely available to all and some areas are restricted to Indegene members. Anyone can choose to be a member with Indegene and he/she will have to provide some basic personal information for the purpose of accessing of information. This information will help us to provide you a personalized experience on our sites and improve our marketing services.
Under no circumstances shall we be liable for any special or consequential damages that results from the use of, or the inability to use, the websites and the materials in it.
For any question or to request modification or deletion of your personal information, please e-mail firstname.lastname@example.org. In case if you have feel your privacy was violated, you may report this a possible breach to Privacyofficer@indegene.com, stating the details of breach and sharing the possible evidences.