The Right Fit Is All In The Genes

As the future of healthcare continues to evolve, consultants, brokers, and employers are looking to healthcare leaders to find new, better, more comprehensive ways to reduce costs and improve health satisfaction and overall patient outcomes.

According to a study conducted by Willis Towers Watson, employers are currently “moving away from one-size-fits-all health benefits to providing employees with more options to choose from so their individual needs can be met.” With this trend in mind, it’s important for insurance consultants and brokers to expand their knowledge base to keep their clients at the forefront of the latest trends in healthcare. One topic that has been gaining traction in the healthcare industry is the field of personalized medicine.

The excitement surrounding personalized medicine has stemmed from recent advances in genome-based technologies that assess variations at the DNA, RNA, protein, and metabolite level. In particular, pharmacogenetics (PGx) and disease-related genetic tests that help identify predisposition for disease and predict adverse drug response or likelihood of response.

In an article written for Health Essentials from Cleveland Clinic, Dr. Charis Eng MD, PhD, states “… the pendulum is swinging now in favor of patients. If your doctor recommends genetic testing, most insurance will cover it partially or fully. Why? Because these tests are accurate, effective, and backed by evidence. Insurance companies know this. They also know that paying for colonoscopies at age 25 for a patient with Lynch Syndrome costs less than paying to treat cancer that has spread later in life. Appropriately, many insurance companies now also ask for genetic counseling as a prerequisite to covering genetic testing.”

Dr. Eng also states that “genetic counseling helps eliminate ‘trial and error’ medicine, which is why [many] insurers recognize its value. Keeping you healthy isn’t just good for you—it’s good for a payer’s bottom line.” Therefore, insurers should support the potential cost savings that stem from more precise treatment methods, the potential to avoid costly treatment in the future, and a better understanding of your own individual health.

In short, by supporting the coverage and favorable reimbursement of medical services that place emphasis on precise treatment methodologies, preventive health, quality of care, and improved outcomes, employers and consultants alike can urge the healthcare industry to evolve and change while positively impacting the health of employees and organizations.