Manage advanced diagnostics with networked infrastructure

Key Points

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.

Personalized medicine includes choosing not necessarily the least expensive test, but the test that will drive action to the best outcome, at the right cost over time. Achieving administrative simplification and smart, efficient testing requires an alignment of all parties: physicians, insurers, labs and patients. To do so, one solution to consider is a "networked marketplace for advanced diagnostics." That is, connecting all stakeholders to deliver the best result at the best cost.

Much is at stake in the testing alone. Molecular diagnostics spend-including genetic tests, pharmacogenomics and infectious disease assays-has grown from $1.4 billion in 2005 to $6.2 billion in annual medical costs in the United States, according to a Washington G-2 Reports 2010 survey. It represents a 28% compounded annual growth rate. The survey predicts that molecular tests, costing $300 to $3,000 per test, soon will account for one-third of all diagnostic testing costs. And new tests continue to enter the market at a rapid pace.