Strategies may include:
(1)
Inform physicians about the cost of testing, for example by posting charges for high-cost tests at order entry.
(2) Develop guidelines or protocols with defined test strategies.
(3) Monitor physician test volume and compare with peers.
(4) Monitor patients for repetitive tests not part of an established protocol.
(5) Provide education to improve habits, especially for medical students and residents.
(6) Restrict certain tests.
(7) Enforce exclusions for inappropriate specimens or testing.
(8) Limit the number of times that a test can be ordered at one time.
(9) Give feedback, including benchmarks.
(10) Improve laboratory efficiency and reporting.
(11) Eliminate economic or perverse incentives.
In some practice settings like managed care a physician who does order laboratory tests appropriately may be penalized or even fired.
