Manage advanced diagnostics with networked infrastructure

The promise of advanced diagnostics is that they match a patient with the best test, leading to the treatment with the greatest chance of success. A health plan's policies for appropriate use of such advanced diagnostics can influence optimal outcomes. Much is at stake in the testing alone. Molecular diagnostics spend -- including genetic tests, pharmacogenomics and infectious disease assays -- has grown from $1.4 million in 2005 to $6.2 billion in annual medical costs in the US, according to a Washington G-2 Reports 2010 survey. Managing this explosive growth has been challenging on many fronts. Creation of explicit tracking and billing codes -- one unique code for each unique test -- has not kept pace with the arrival of new tests. A networked marketplace is a mechanism to reduce administrative overhead and make services available to more users. For advanced diagnostics, a networked marketplace would connect a health plan with its ordering physicians, par and non-par labs, genetic counselors, specialty pharmacies and pharmacy benefit managers.