As hospitals fight for their portion of reimbursed health care expenditures, it will become increasingly necessary to investigate alternative funding mechanisms. In-house laboratories, which have likely been seen in the past as pure cost centers, can be repositioned to provide additional revenue to hospitals. This opportunity for in-house laboratories to be remade into profit centers is predicated upon a thorough understanding of the environmental factors affecting hospital laboratories. This article examines 4 distinct environmental factors: demographic and socioeconomic trends, reimbursement and financing, government policy, and clinical events. Each of these external environmental factors provides 2 broad sources of interest to hospitals and their in-house laboratory components: opportunities on which to capitalize and hazards against which to defend.