Genetic Test Ordering Management Programs Can Save Costs

As use of clinical molecular testing skyrockets, many believe a closer examination of ordering patterns is warranted. Molecular tests have the potential to offer key diagnostic information. However, if not properly ordered these tests can be expensive and still not provide the needed answers to key clinical questions. A few early studies have shown that misorders are common and can result from clerical errors, misunderstanding of genetics, or inappropriate testing sequences. These misorders can both be costly to the health care system and delay appropriate diagnosis and treatment. As a result of increasing health care costs associated with molecular testing, many institutions are undertaking a review of test orders in formal genetic test utilization management (GTUM) programs. Three studies presented recently at the American College of Medical Genetics and Genomics (ACMG) Annual Clinical Genetics Meeting demonstrate the savings associated with improving molecular test ordering practices.

The early results of existing GTUM programs can provide guidance to laboratories and medical systems on the benefits of reviewing genetic test orders. GTUM led to improved financial management of the testing process, including limiting of patient financial liability and increasing institutional reimbursement, according to an oral presentation at ACMG by Julie Kaylor, a certified genetic counselor at Arkansas Children’s Hospital. Additionally, the review of testing orders led to further refinement of the GTUM program by addressing additional sources of ordering errors.

For more in-depth discussion of the studies, see “ACMG Studies Provide Lessons in Genetic Test Ordering Management,” in the April 2016 issue of Diagnostic Testing & Emerging Technologies. At the 34th Annual Lab Institute, NextGxDx Founder and CEO Mark Harris and Vice President of Clinical Development Gillian Hooker will examine the challenges of providing cost-effective molecular diagnostics and the implications of a comprehensive online marketplace for genetic testing services.