Is the term “outreach” obsolete?
Laboratory “outreach” has been an industry activity in the United States for over 50 years. With the introduction of federally insured healthcare in 1965, utilization of all medical services increased, including laboratory testing. As healthcare costs skyrocketed, in the 1980s, insurance companies and governmental payors implemented a variety of cost-containment strategies. Combined with technological advancements and improvements in care, many of these strategies helped to drive patients out of the hospital and into the outpatient setting.
With an increase in outpatients, there was a fresh opportunity for laboratories to expand services and serve external providers. Most physicians were in private practices and had autonomy in their choice of laboratory services. Provider choice for laboratory services was driven by such factors as convenience, reliability, and ease of use. Hospital laboratories that invested in delivering a customer-centric service outside their hospital walls realized success in their “outreach” programs.
The past 20 years have seen a shift in provider behavior; currently, around 74% of physicians and mid-level providers are employed or tightly affiliated with health systems1, thus the concept of “outreach” has morphed. Employed providers are considered part of the health system, thus making it easier for them to access hospital-based services, including the laboratory. Today, the term “inreach” is commonly used to describe services provided to these outpatient providers who are within the health system.
Is the term “outreach” dead? If so, what should it be called instead? The playwright William Shakespeare famously wrote, “What's in a name? That which we call a rose by any other name would smell just as sweet.” He suggests that the naming of things is irrelevant.
The term “outreach” may refer to a physician business model that is a couple of decades old, but the concept of providing discretionary laboratory services to the community is timeless.
Today, the choice of laboratory services may depend on several factors. The continued presence of independent laboratories is evidence that the community-based hospital does not hold complete control of the outpatient laboratory market, regardless of provider employment status. In our experience, the hospital laboratory rarely holds 100% of its “inreach” market. Instead of focusing on a name, a better approach may be to understand what the service is, how it is accessed and valued, what the customer or consumer needs from the laboratory, and how it benefits the health system overall.
When choosing a laboratory, a provider may seek out the following differentiators:
In a competitive outpatient testing market, choosing a laboratory is discretionary. With the goal of becoming the laboratory of choice for discretionary outpatient testing, it no longer matters if it is called “inreach” or “outreach.” While these terms may be decent descriptors for a process, they do not begin to describe the true value of this critical community laboratory activity. The value of a laboratory outreach program spans all areas of relevance for a health system. Through supporting clinical integration and community health initiatives, the laboratory is a critical element, enabled and supported by a successful outreach activity.
Is the name “outreach” obsolete or dead? The mechanism of outreach is critical to supporting patient integration and community health. “Outreach” is the mechanism that allows the laboratory to deliver an aligned service that supports the health system’s outpatients, driving positive outcomes for all concerned.