Optum Launches Laboratory Benefit Management Solution to Reduce Unnecessary Testing and Improve Quality of Care
Optum has launched a new laboratory benefit management solution aimed at health plans to reduce unnecessary lab testing and improve quality. This initiative could save health plans between $12-$36 per member annually, totaling over $3 billion in savings. The solution addresses the issue of approximately 30% of lab tests being unnecessary, which can lead to increased patient risks and costs. By aligning lab testing with evidence-based guidelines, Optum aims to deliver better clinical outcomes and streamline laboratory administration for health plans.
- Potential savings of
$3 billion annually for health plans. - New solution helps align lab tests with evidence-based guidelines.
- Automates lab benefit administration, increasing efficiency.
- Roughly 30% of clinical lab tests are deemed unnecessary, indicating pervasive inefficiencies in the current system.
The comprehensive solution aligns testing with clinical evidence, helping health plans better manage lab test utilization and spending
The potential savings for health plans range from
Unnecessary lab testing is widely recognized as wasteful and potentially harmful to patients. Roughly 13 billion clinical lab tests are performed every year, making it the most utilized medical benefit.1 Health plans spend tens of billions of dollars on lab tests annually ― yet studies show that
Tests not clinically indicated can lead to unnecessary sample collection from patients and increased chances of incorrect results. The absence of industry standards and clinical efficacy data exacerbates misuse and misinterpretation of tests, often leading to inappropriate and unnecessary interventions.3
Given these challenges and as more lab tests enter the market, health plans need a solution to address the current lack of test management and oversight.
“Lab testing is one of the most common touch points in health care and the benefit health plan members use most often,” said
Challenges are growing with frequent advances in genomics testing, which can assess a person’s genetic code to evaluate the personal risk of contracting one or more specific diseases. Optum’s new solution includes a multi-organizational team of clinical experts to develop evidence-based lab policies and evaluate new tests in this rapidly growing and evolving space.
“Testing is expanding so rapidly that most clinicians do not have the bandwidth to stay up-to-date on which ones are the highest quality. As clinicians, we all want reliable test results as we make decisions for our patients,”
This laboratory benefit management solution is now available to all health plans. Additional information is available here Optum/Laboratory Benefit Management.
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1 Price, Christopher & St John, Andrew. (2014). Clinica Chimica Acta. Anatomy of a value proposition for laboratory medicine. 436, 104–111.
2 Zhi M, Ding EL,
3
About Optum
Optum is a leading information and technology-enabled health services business dedicated to helping make the health system work better for everyone. With more than 210,000 people worldwide, Optum delivers intelligent, integrated solutions that help to modernize the health system and improve overall population health. Optum is part of
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Optum Media Contact:
202-549-3429
gwen.m.holliday@optum.com
Source: Optum
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