Chapter 42 : Outreach Implementation Requirements: A Case Study

Table 42.1

2002 BRL outreach laboratory utilization analyzed by specialty

Table 42.2

Beaumont Reference Laboratory’s annual client numbers and clinical pathology procedures

a Total clinical pathology procedures include inpatients, hospital-registered outpatients, and BRL clients.

Table 42.3

Courier routing optimization results: the BRL experience

Table 42.4

Route-optimization results: rerouting for cold weather

Table 42.5

Route optimization results: reoptimization of Monday p.m. routes

Table 42.6

Annual volume of tests of cervical cytology at BRL a

a Data collected by Jennifer Shimoura.

b Liquid-based cytology specimens continued to be greater than 95% of GYN specimens annually from 2005 to 2011.

Table 42.7

Tests performed in 2002 in the molecular pathology laboratory at William Beaumont Hospital

a RT-PCR, reverse transcriptase PCR; HCV, hepatitis C virus; HIV, human immunodeficiency virus; HBV, hepatitis B virus; CMV, cytomegalovirus; ACE, angiotensin-converting enzyme; TMA, transcription-mediated amplification; MTHFR, methylene tetrahydrofolate reductase; HPV, human papillomavirus.

b The test menu had increased to more than 45 billable procedures in 2011.

Table 42.8

Summary of tests performed by BRL in 2002 according to specialty

Table 42.9a

Breakdown of tests performed by BRL in 2002 according to specialty

a CHE, chemistry; HEM, hematology/coagulation; IMM, immunology; MIC, microbiology; MOL, molecular pathology; FLO, flow cytometry; BLB, blood bank; CYT, cytology.

Table 42.9b

Breakdown of tests performed by BRL in 2002 according to specialty

a CHE, chemistry; HEM, hematology/coagulation; IMM, immunology; MIC, microbiology; MOL, molecular pathology; FLO, flow cytometry; BLB, blood bank; CYT, cytology.

Table 42.10

Frequently ordered tests performed by BRL in 2002 listed in rank order according to specialty

a E2, estradiol; U/A, urinalysis; ESR, erythrocyte sedimentation analysis; Ab, antibody; Ag, antigen; E3, estriol; Prel, preliminary; Def, definitive; HS, high sensitivity; HH, hemochromatosis gene mutation; ID, identification; cul, culture.

Table 42.11

Send-out test volumes at William Beaumont Hospital a

a The distribution in percentage for BRL vs. non-BRL send-out specimens remains approximately the same. The total volume exceeded 100,000 in 2011.

b Non-BRL represents inpatient, emergency center, and registered outpatient send-out procedures.

Table 42.12

Review of send-out tests by telephone at William Beaumont Hospital

Table 42.13

Potential areas to monitor to track financial outcome in an outreach program

Table 42.14

Annual revenue at BRL a

a From 2003 to 2011 the gross and net revenues generally increased in proportion with the total procedure count. At the specific procedure level there are exceptions based on Centers for Medicare and Medicaid Services changes in billing policies.

b Total procedures performed by BRL in anatomic and clinical pathology.

Table 42.15

Payor mix for four years at BRL a

a The payor mix has fluctuated with the local economy and changes in unemployment in the state of Michigan.

b Comprises capitated and fee-for-service contracts.

Table 42.16

Annual statistics relating to procedures performed by BRL

a Total procedures performed by BRL in anatomic and clinical pathology.

Table 42.17

Comparison of procedures and revenue for BRL and JVHL business

a Refers to all BRL business and all payors (Medicare, Blue Cross, JVHL, etc.).

b Refers to the total revenue for clients with JVHL activity and includes JVHL-only gross revenue column.

c Refers to JVHL capitated contracts (payments) only and excludes pull-through business.

d NA, not applicable.