Generation Health Genetic Testing Management Strategies
No two genetic tests are alike. That is why Generation Health has developed strategies to meet the growing challenges of testing for both medical diagnostic (MDx: evaluating the risk or confirming the diagnosis of hereditary disease) and pharmacogenetic testing (PGx: evaluating an individual's genes to determine if a drug will be effective). They are as follows:
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Coverage Framework |
Evaluates the clinical merits of each test and enforces recommended coverage policies through plan edits. With 100 new tests being added every year, this framework for making and enforcing coverage decisions is essential.
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Utilization Management |
Ensures tests are ordered appropriately. In response to over marketed tests, prior authorization can be established to ensure patients that would benefit from testing receive the appropriate care.
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Best Test Lab |
Generation Health is establishing a “best test” laboratory network aimed at offering patients, physicians, and payors the highest quality, most cost-effective genetic testing services. Our lab network will support physician’s needs for information to enable integration of testing into their clinical care.
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Outreach Programs
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Through rigorous clinical and economic analysis, Generation Health identifies testing opportunities to reduce overall healthcare spending. Our PGx programs will ensure that drug spend is not “wasted” on patients who will be unresponsive to targeted therapies or are genetically predisposed to experiencing adverse events.
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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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