The Need in the Current Environment
With finite budgets, the need to obtain the best value from limited funds will motivate health care payors to reimburse only for those tests that provide a health benefit and that are cost effective. Currently:
- Genetic (or Genomic) testing represent a $3B market growing at 45% annually.
- This growth in testing reflects the rapid progress of science and technology as well as growing physician and consumer awareness fueled by the medical coverage of scientific breakthroughs as well as the emergence of "personal genomics" companies.
- As a result, some tests are being used before their clinical utility is understood while in other cases, opportunities to use testing to inform better care are missed.
- At a payor level, coverage and reimbursement in employee benefit plans is ad hoc and expenditures are largely unmanaged.
Optimizing the use of genetic testing with the help of a trusted third party will become a critical need for health care payors over the next several years.
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Generation Health's Mission
Generation Health will work on behalf of payors to manage a systematic, comprehensive, and cost-effective process for the administration of genetic testing benefits to control clients' costs and improve members' health.
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