A study from the Obama administration published in Journal of Health Affairs
suggests that healthcare spending has hit an all-time high and will only continue to grow. From 2015 to 2025, health spending is expected to grow an average of 5.8 percent a year and these numbers are not adjusted for inflation.
The study suggests that many factors contribute to these rises in spending including specialty drugs and changes in the economy.However, one thing that may also help to reduce spending and improve patient outcomes is optimized clinical lab testing.Most clinical decisions are based in some measure of results of laboratory tests. In addition to routine tests to screen for diabetes, heart disease and other conditions, clinical testing increasingly involves advanced diagnostics. These tests, such as next generation sequencing to help identify cancer risk, aid the prediction and diagnosis of complex diseases. They can also help physicians identify and monitor appropriate treatments.Despite their critical role in patient care, lab tests only account for 2-3 percent of overall healthcare costs. Moreover, genetic laboratory tests increasingly help identify people who are suitable for comparatively expensive drug therapies -- and rule out those who are not – to further save the healthcare system money.And underutilization of laboratory testing may be more prevalent than overutilization, according to results of a meta-analysis.To help ensure adequate utilization of medically appropriate tests, clinicians should optimize the testing process and employ interventions to guide them to the most appropriate tests for their patients.
- First, physicians and health systems need to recognize that the more complex or more expensive test is not always better.
- Second, clinicians should consider the use of analytics to help guide their test choices.
- Third, physicians and health systems need to have access to experts who can help guide test selection and interpretation.
- Finally, clinicians should avoid testing to “rule in” a condition when it is not appropriate.
As science and innovation advance, clinicians will surely be faced with new challenges associated with appropriate use of diagnostic laboratory testing. But they will also be presented with opportunities to access diagnostic innovations that can help improve care quality and cost effectiveness. Implementing the appropriate protocols to ensure optimal testing practices will benefit patients and healthcare systems.
Keehan, Sean P. National Health Expenditure Projections, 2015–25: Economy, Prices, And Aging Expected To Shape Spending And Enrollment. Journal of Health Affairs. July 2016.