Some managed care organizations (MCO) may find difficulty in determining which genetic tests to cover with roughly 67,000 in existence to date, but that’s not stopping them from trying.
“Certain genetic tests can provide information that not only identifies which treatments will be most effective, but also help patients avoid potentially harmful or even lethal treatments and exposures,” Lewis says. “For tests that meet our medical management outcomes benchmark, morbidity and mortality is sometimes tremendously reduced. Often, genetic information allows for screening that leads to early detection, reducing the medical and financial impact for both the member and health system.”
But each health plan has a different approach to their evaluation processes.