Utilization Management 2014: Demonstrating and Delivering Value

UM-Ad-v3The Utilization Management 2014 conference will focus on the reasons and practical how-to approaches that will better enable hospital laboratories and pathology practices to move toward value based medicine. Health care requires collaboration between patients, the hospital, physicians, pathologists and payers. New measurements are taking hold to include shared risk payment, quality impacts to reimbursement and realigned incentives. Test utilization management is an integral part of improving quality and outcomes at a lower cost.

Upon completion of the conference, participants should be able to:

  • Identify tools and strategies that may be useful in both evaluating and controlling test utilization
  • Analyze the causes behind inappropriate utilization of laboratory tests
  • Recognize the value of utilization management to both in-patient and out-patient populations
  • Communicate the value of utilization management to ordering physicians for all sites of care
  • Develop and implement utilization support and processes

Conference attendees can expect to learn the following:

Sept. 22 5:30-6:30 p.m. Keynote Presentation: Payers and Pathology Working Together to Create Value: Lee Newcomer, M.D., UnitedHealth Group Senior Vice President, Oncology, Genetics and Women’s Health will share his perspectives on how laboratories, policy makers, health care institutions and payers can work together to improve value, transparency and standardization in the continuum of care.
Sept. 23 8:15-9:15 a.m. Setting the Stage: The conference will kick-off with a dynamic presentation by Dr. Curt Hanson, Don Flott and Kari Asuncion from Mayo Clinic, Rochester. They will discuss the critical need for optimizing laboratory test utilization in today’s health care environment and how laboratory leaders can champion test utilization efforts at their institution.
Sept. 23 9:30-10:15 a.m. Beginning Utilization at the Time of Order Entry: The best time to improve test utilization is at the time of provider ordering, before the sample is obtained and is received by the laboratory. Dr. Pritt will provide multiple examples of simple to advanced ways of guiding provider ordering using their existing ordering tools and systems.
Sept. 23 10:15-11:00 a.m. Utilization Management in Anatomic Pathology: A comprehensive laboratory test utilization program must extend beyond the clinical laboratory to include Anatomic Pathology, especially as ancillary complex testing on tissue specimens becomes necessary for patient care. Learn how a multidisciplinary approach (Clinician, Anatomic Pathologist and Clinical Pathologist) can help to guide a best practice approach to utilization, and how standardization in the Anatomic Pathology practice encourages effective utilization of health care resources.
Sept. 23 11:00 a.m.-12:30 p.m. Practical Solutions Across Laboratory Medicine: In this interactive presentation, our panel of Mayo Clinic faculty will provide several real-life examples of successful approaches for optimizing laboratory test utilization.
Sept. 23 1:30-2:30 p.m. Leveraging Genetic Counselors: Genetic testing presents unique challenges to the value equation because the tests are expensive, insurance coverage is inconsistent, and provider knowledge of testing options is inconsistent across specialties. This practical session discusses how genetic counselors and doctoral-level laboratory staff can create a successful utilization management system to provide significant cost savings to the hospital and increase value to patients.
Sept. 23 2:30-3:30 p.m. How to Create a Successful Utilization Management Program in the Community Hospital Setting: Community based hospitals face many of the same challenges as large hospital systems in controlling the costs of blood products and laboratory testing, but may have limited resources and personnel to tackle these issues. This talk will focus on how the pathologists and their colleagues at Bronson Methodist Hospital have decreased red blood cell transfusions by 25%, controlled point of care testing and put the brakes on expensive boutique laboratories and genetics testing.
Sept. 23 3:45-4:45 p.m. Lessons Learned from a Large Health System: In this presentation Jim Crawford, M.D. will present the lessons learned from implementing a Utilization Management program into a large health system.

Kelley Schreiber

Kelley Schreiber is a Marketing Channel Manager at Mayo Medical Laboratories. She is the principle editor and writer of Insights and leads social media and direct marketing strategy. Kelley has worked at Mayo Clinic since 2013. Outside of work, you can find Kelley running, traveling, playing with her new kitten, and exploring new foods.