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Up to 35% of patients would switch PCPs for genetic testing. But is it a good investment for you?

January 8, 2019

    Preventive forms of genetic testing, specifically predictive and pharmacogenomic testing, are two of the most recent disruptors in health care. While predictive genetic testing examines healthy individuals for genetic variants that may lead to disease, pharmacogenomic testing examines how an individual may react to different medications.

    Make these 14 investments to win primary care patients

    Often offered together as part of the same testing panel, predictive and pharmacogenomic testing are offered in select primary care practices looking to advance population health and attract new patients.

    For example, NorthShore University has found that genetic testing helps better manage the care of participating patients, as health concerns can be identified earlier. To date, 15% of participants have been proactively referred to specialty care. Additionally, 35% of patients surveyed across the system indicated they would switch primary care physicians (PCPs) for access to preventive genetic testing, suggesting this investment could increase patient acquisition and retention.

    Genetic testing in primary care can offer significant direct and downstream growth opportunities, but how can you judge if genetic testing is the right investment for you? Here are two factors to consider before adding genetic testing to your primary care practices:

    1. Consider PCP buy-in and training requirements

    Effective genetic screening in primary care ultimately depends on PCPs ordering and correctly interpreting genetic testing panels. However, a survey of nearly 500 New York PCPs found that only 25% feel prepared to work with genetic screening patients. Additionally, a new report by Quest Diagnostics found that up to 30% of genetic tests, including more common types of diagnostic tests, are ordered incorrectly.

    Before launching a primary care genetic testing program, consider the willingness of your PCPs to order and interpret these tests, as well the training they may require.

    2. Consider local insurance coverage and potential system costs

    Currently, prenatal, hereditary cancer, and oncology treatment screenings constitute 90% of commercial insurance reimbursement for genetic tests. Meanwhile, there is minimal insurance coverage for predictive and general pharmacogenomic testing.

    This lack of insurance coverage, combined with the high cost of genetic testing, has required providers to limit their testing panels and either absorb the cost themselves, or offload the cost to patients. For example, Geisinger uses a 77-variant test for the 1,000 patients in its trial, paying only to examine a subset of genes. NorthShore also uses a limited panel, but its 8,000 patients have had to absorb the one-time testing cost, which can be as high as $500.  

    Before investing, consider how you will limit your testing panels in order to make this investment financially feasible. Additionally, consider if you will absorb the costs of genetic testing or pass that fee directly on to enrolled patients.

    Overall, genetic testing in primary care can help health systems appeal to consumer preferences, grow their downstream volumes, and advance their approach to population health management. But before you invest, consider the training your PCPs may require and the extent to which you, or your patients, can absorb testing costs.


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