In the News: May 17–24

Market for Genetic Tests Shows Rapid Growth

A new Health Affairs study found the number of genetic tests on the market and spending on such tests has grown rapidly since 2014. According to the study, there were 75,000 genetic tests by August 2017, with about 10 new tests entering the market per day between 2014 and 2017. Prenatal tests accounted for the highest proportion of clinical spending on genetic testing, ranging from 33% to 43% of spending between 2014 and 2016. Single-gene tests comprised 86% of the tests on the market.

Although investment in DNA-based tools has increased significantly since the mapping of the human genome in 2003, the number of tests on the market and how they are used has been largely unknown. The authors attributed the rapid growth in test availability and spending to several factors such as increased understanding of the molecular basis of disease, patient demand, industry investment and regulations that allow marketing of genetic tests without FDA approval.

The proliferation of new genetic tests reflects the momentum behind precision medicine. Sg2 believes precision medicine will change care delivery across all service lines and DNA-based technologies must be integrated with enterprise-level analytics to do so effectively. To learn more about planning your precision medicine approach, read the Sg2 Expert Insight, Precision Medicine: Hope, Hype, Here.

Patients Find Challenges When Accessing Their Medical Records

A May 2018 report from the US Government Accountability Office (GAO) analyzed the fees and challenges associated with patients’ access to their medical records. Through multiple interviews with patient advocates, provider associations and other stakeholders, GAO found patients can face high fees that may adversely affect access to their medical records, with some patients canceling their requests due to the potential costs. Additionally, GAO found states have varying laws regarding fees allowed for patient and third-party medical record requests.

In fulfilling patient requests for medical records, GAO uncovered provider challenges such as the adequate allocation of staff time and resources and the storage of information in multiple electronic and paper systems. The report further states providers and patients themselves may be unaware of patients’ rights to access their medical records.

While patients’ access to electronic health information has improved over the past several years, challenges to low-cost, convenient access to health information remain. Sg2 believes health systems should consider patient access to electronic health information as part of their digital health strategy. For further considerations on developing a digital health strategy that drives the greatest benefit for patients, read the recent Expert Insight, Is Health Care Ready for the Digital Health Tsunami?

ACOs Reevaluate Participation in the MSSP

A recent Modern Healthcare article described the turbulent experience of a rural accountable care organization (ACO) that will leave the Medicare Shared Savings Program (MSSP) in response to rising pressure to assume risk. Since 2012, Chautauqua Region Associated Medical Partners has been a part of an upside-only model under MSSP Track 1.

As a participant, the rural-based ACO saved Medicare roughly $6.7 million, with $3 million of that returned to the organization in savings. Despite strong savings performance, the practice is feeling pressure to assume risk and compete in a highly penetrated managed care market. Without further opportunities for cost containment, the ACO runs the risk of compromising care services delivered to their roughly 7,000 Medicare beneficiaries. The article highlights a recent survey by the National Association of ACOs, which found almost 71% of ACOs founded in 2012 or 2013 are considering leaving the MSSP if forced to take on more risk.

Rural ACOs have generally outperformed peers, realizing savings while maintaining lower utilization. Sg2 believes that health systems can take a strategic approach to risk without having to build a complex integrated delivery network. To learn more on how rural partners can help on the path to value-based care, read the Sg2 Expert Insight, Managing Risk Without Scale.

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