Getting Health Plans & Providers in Sync with Genetic Tests

The Hayes Client Symposium is under two months away and our accredited sessions are taking shape for our clients who are attending. Few areas of healthcare are changing as rapidly as the field of genetics—from new tests coming to market weekly, to proposed changes in regulation. We’re pleased to be offering a session focused on this evolving topic.

As you can see from the figure below, the increase in the number of available genetic tests has been nothing short of exponential from 1993 to 2016, driven substantially by introduction and use of next-generation sequencing. This technology has led to the expansion of multi-gene panel tests as well as availability of whole exome and whole genome sequencing. Although next-generation sequencing has resulted in a decrease in the cost per genome ($1000 genome, anyone?), there are numerous challenges that remain to be worked out—including when these tests are clinically useful.

Patients have become increasingly aware of genetic testing for some conditions. For example, Angelina Jolie’s 2013 op-ed letter to The New York Times described the actress’ decision to undergo a prophylactic double mastectomy and subsequent prophylactic oophorectomy as a result of learning she carried a BRCA1 variant associated with increased cancer risk. The public response to this disclosure, the so-called “Angelina Jolie effect,” increased referrals to genetic counselors and genetic testing for BRCA1 and BRCA2. Genetic testing is also becoming a component of patient-centered care, particularly for oncologists. But when and how to integrate genetic testing into patient management is still a developing practice. Health systems and providers are working through how to manage the costs involved with genetic testing, developing workflows for ordering and reporting test results, and navigating reimbursement by third-party payers.

At our Client Symposium, taking place in Philadelphia in September, we’ll take a closer look at the role of medical necessity for genetic testing and system-wide approaches used to integrate genetic testing into clinical care, including:

  • The current state of genetic testing
  • Overview of third-party reimbursement for genetic testing
  • The role of genetic testing in evidence-based medicine

Join us in Philadelphia for what is certain to be an informative and interactive day. In addition to a review of genetic testing, we’ll have sessions on the FDA approval process and specialty drugs. The full agenda of the Hayes Client Symposium and access to registration is available at: http://www.hayesinc.com/hayes/hayes-2016-client-symposium/agenda/.

2016 Client Symposium

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