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Implementing a Test Utilization Management Program: Combining Medicine and Management
This presentation will examine test utilization from both a medical and managerial perspective, focusing on information that guides utilization management efforts, such as inappropriate test ordering, and how tiering can be used to guide interventions. Also discussed will be various interventions used to control utilization, including their advantages and disadvantages, as well as managerial approaches to the implementation of a successful utilization program. Finally, case studies illustrating how effective utilization management can reduce costs and improve the quality of care will be presented.
Originally presented on August 25, 2014 in Salt Lake City, Utah.
Casey Leavitt, MBA
Program Director, Consultative Services Business Development, ARUP Laboratories
Ms. Leavitt has worked in the healthcare industry for 19 years and is currently the consultative services program director at ARUP Laboratories. Prior to her position at ARUP, Ms. Leavitt was the referral development director for University of Utah Health Care, where her primary responsibility was to develop and strengthen relationships with the university’s regional referring providers and facilities. She was also the director of managed-care contracting for the University of Utah Medical Group, where she was responsible for negotiating contracts, worth more than $220 million in annual revenue, with commercial payers on behalf of over 850 primary and specialty care physicians. Ms. Leavitt has worked for a number of healthcare startup organizations and began her career at Intermountain Health Care, implementing several successful projects focused on operational efficiency, patient satisfaction, and quality improvement. She received her MBA from the University of Utah and her bachelor’s degree from Utah State University.
After this presentation, participants will be able to:
- Describe approaches used to identify tests with a high likelihood of misutilization.
- List common tests that are frequently misutilized.
- Describe how risk assessment is used to prioritize tests.
- Describe how tiers are used to simplify.
- Describe general management principles of successful implementation.
University of Utah School of Medicine, Department of Pathology, and ARUP Laboratories