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Chapter 30 : Financial Management: Setting the Stage

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Financial Management: Setting the Stage, Page 1 of 2

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Abstract:

This chapter establishes the importance of the environment in which the laboratory operates. It concentrates on hospital and independent laboratories, which usually perform moderate- and high-complexity testing. In the hospital institutional environment, the laboratory usually operates as a division under a vice president or director of operations. Along with other operational divisions such as pharmacy and dietary, the laboratory must compete for resources with direct patient care divisions such as nursing. The major differences in the cost and operational structures of independent and hospital laboratories lie in the patient populations and the nature of the services provided. Many hospital laboratories, especially those in academic medical centers, serve significant numbers of outpatients. These encounters with the outpatient facility may be associated with prior or future inpatient stays, for example, before or after surgical procedures. In this outpatient arena, hospital laboratories compete with the commercial laboratory sector for business. Independent laboratories serve an outpatient population. The small independent laboratory has the advantage of flexibility and the ability to move quickly to adapt to the market; it is not burdened with hospital administrative overhead and cumbersome decision-making processes. The independent laboratory industry has rapidly consolidated, the number of independent laboratories has plummeted; two large public corporations now dominate the industry, and consolidation continues apace.

Citation: Lepoff R. 2014. Financial Management: Setting the Stage, p 567-572. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch30

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Figures

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Figure 30.1

The organizational chart of a hospital that is organized in a traditional manner. Note that the chief operating officer, who is parallel in reporting responsibility to the VP of nursing, is responsible for all ancillary services through a director who is responsible for operations. doi:10.1128/9781555817282.ch30.f1

Citation: Lepoff R. 2014. Financial Management: Setting the Stage, p 567-572. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch30
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References

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1.Centers for Disease Control and Prevention. 2001. National Hospital Discharge Survey. Centers for Disease Control and Prevention, Atlanta, GA.
2.Centers for Medicare and Medicaid Services. 2012. Acute Inpatient Prospective Payment System. http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/index.html (last accessed August 30, 2012).
3.Centers for Medicare and Medicaid Services. 2012. Hospital Outpatient Prospective Payment System. http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/index.html (last accessed August 30, 2012).
4.Centers for Medicare and Medicaid Services. 2012. CLIA Statistical Tables/Graphs. http://www.cms.gov/Regulations-and-Guidance/Legislation/CLIA/CLIA_Statistical_Tables_Graphs.html (last accessed September 4, 2012).
5.National Center for Health Statistics. 2012. Health, United States, 2011: With Special Feature on Socioeconomic Status and Health. Table 103. http://www.cdc.gov/nchs/hus/contents2011.htm#103 (last accessed September 14, 2012).
6. Travers, E. M. 1997. Clinical Laboratory Management. Williams & Wilkins, Baltimore, MD.
7. Valenstein, P.,, A. Praestgaard,, and R. Lepoff. 2001. Six year trends in productivity and utilization of 73 clinical laboratories: a College of American Pathologists Laboratory Management Index Program Study. Arch. Pathol. Lab. Med. 125:11531161. [PubMed][CrossRef]
8.Washington G-2 Reports. 2003. Laboratory Industry Report, vol. 12, no. 42003.

Tables

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Table 30.1

The demographics of the laboratory industry

See reference . All numbers approximate.

Citation: Lepoff R. 2014. Financial Management: Setting the Stage, p 567-572. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch30
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Table 30.2

Components of diagnostic laboratory testing

Citation: Lepoff R. 2014. Financial Management: Setting the Stage, p 567-572. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch30
Generic image for table
Table 30.3

Factors that produce inefficiency in hospital-based laboratories that serve inpatients

Citation: Lepoff R. 2014. Financial Management: Setting the Stage, p 567-572. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch30
Generic image for table
Table 30.4

Laboratory productivity and volume

Data from Laboratory Management Index Program of the College of American Pathologists (1994).

Citation: Lepoff R. 2014. Financial Management: Setting the Stage, p 567-572. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch30
Generic image for table
Table 30.5

Reimbursement mechanisms in the inpatient, outpatient, and independent laboratory settings

Citation: Lepoff R. 2014. Financial Management: Setting the Stage, p 567-572. In Garcia L (ed), Clinical Laboratory Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817282.ch30

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