Browsing by Subject "cost containment"

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    Cost Containment and the Patient Protection and Affordable Care Act
    (2010) Orentlicher, David
    For decades, the U.S. health care system has grappled with two key problems – inadequate access to coverage and increasingly unaffordable health care costs. Paradoxically, the U.S. spends far more of its gross domestic product (GDP) on health care than do other economically-­advanced democracies, yet provides health care insurance to fewer of its citizens. During the debate that led to the enactment of the Patient Protection and Affordable Care Act, public officials recognized the need to address the problems of both access and cost, but in the end, the Act does far more about increasing access than it does about cutting costs. This result is not surprising. As a matter of politics, it is much easier to sell the public on more benefits than greater sacrifice, so cost control was largely left to another day. To be sure, taking a wider-coverage-­first, cost-containment-­second approach is not unique to the Affordable Care Act. Health care reforms typically expand access initially and envision cost containment as the next step. That was the approach of Medicare and Medicaid in 1965; it also was the strategy for Massachusetts when it passed its health care reform in 2006. Still, we are left with the question whether future Congresses will implement the measures necessary to tame health care cost inflation or whether uncontrolled costs will cause the Affordable Care Act to unravel.
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    Reduction in Unnecessary Clinical Laboratory Testing Through Utilization Management at a US Government Veterans Affairs Hospital
    (Oxford, 2016-03) Konger, Raymond L.; Ndekwe, Paul; Jones, Genea; Schmidt, Ronald P.; Trey, Marty; Baty, Eric J.; Wilhite, Denise; Munshi, Imtiaz A.; Sutter, Bradley M.; Rao, Maddamsetti; Bashir, Chowdry M.; Department of Pathology and Laboratory Medicine, IU School of Medicine
    Objectives: To implement an electronic laboratory utilization management system (laboratory expert system [LES]) to provide safe and effective reductions in unnecessary clinical laboratory testing. Methods: The LES is a set of frequency filter subroutines within the Veterans Affairs hospital and laboratory information system that was formulated by an interdisciplinary medical team.Results: Since implementing the LES, total test volume has decreased by a mean of 11.18% per year compared with our pre-LES test volume. This change was not attributable to fluctuations in outpatient visits or inpatient days of care. Laboratory cost savings were estimated at $151,184 and $163,751 for 2012 and 2013, respectively. A significant portion of these cost savings was attributable to reductions in high-volume, large panel testing. No adverse effects on patient care were reported, and mean length of stay for patients remained unchanged. Conclusions: Electronic laboratory utilization systems can effectively reduce unnecessary laboratory testing without compromising patient care.