NEW PM103 Establishing a Laboratory Test Utilization Management Program: Organizational Structure, Informatics, and the Central Role of the Pathologist

8:00–11:30 am
3.0 CME CREDITS

Current and future reimbursement models 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). Faculty will share insights from their experience over the past 10 years leading a hospital UMP, including:

The importance of establishing an interdepartmental utilization management organizational structure
Selection of utilization management intervention tools to ensure successful implementation
Design of informatics solutions to monitor utilization data and design of interventions
Cost accounting for utilization management
The pathologist’s role in leading a UMP

You will learn to:

Identify the key elements of a utilization management program
Explain the types of intervention strategies that can be used to implement utilization management initiatives
Describe approaches to cost accounting utilization management initiatives for common and esoteric tests
Discuss why pathologists are uniquely positioned to lead an institutional UMP

Faculty
Anand S. Dighe, MD, PhD
Kent B. Lewandrowski, MD, FCAP