Concert’s unique data and systems make it possible to achieve unparalleled visibility into this space. Again this year, Concert has published price information as observed in a large, commercially insured population. 

This report provides data on the top 20 categories of genetic testing, including areas such as hereditary cancer, oncology, prenatal, exome, and pharmacogenetic testing. Metrics include:

• Median price per test
• Price variability 
• Price change year-over-year
• Average codes per test/claim

The goal of providing this data is to enable greater value, cost-effectiveness, and access in this critical area of precision medicine.

To access the report instantly, complete the form on this page. 

The post 2023 Genetic Test Price Transparency Report appeared first on Concert.

To clear up this confusion, Concert Genetics enlisted leading experts to provide definitive guidance on key questions, such as:

• How does coverage determination differ between MA and Original Medicare?
• What should plans do when criteria is not available in NCD/LCDs?
• What determines the LCD jurisdiction for lab services?
• What are the guidelines for using prior authorization in MA plans?
• Can MA plans establish their own billing, coding and payment policies?
• Can they negotiate rates that differ from the Clinical Lab Fee Schedule?
• Do these rules differ for in-network vs out-of-network lab providers?

For access to the new guide, please complete the form on this page.

The post Genetic Test Coverage and Payment Guide for Medicare Advantage appeared first on Concert.

Concert’s unique data and systems make it possible to achieve unparalleled visibility into this space. For the first time, Concert has published price information on the largest areas of genetic testing as observed in a large, commercially insured population. 

This report provides data on the top 20 categories of genetic testing, covering areas such as hereditary cancer, oncology, prenatal, exome, and pharmacogenetic testing. Metrics include:

• Median price per test
• Price variability 
• Price change year-over-year
• Average codes per test/claim

The goal of providing this data is to enable greater value, cost-effectiveness, and access in this critical area of precision medicine.

To access the report instantly, complete the form on this page. 

The post 2022 Genetic Test Price Transparency Report appeared first on Concert.

Concert Genetics is pleased to offer this in-depth report covering the genetic testing marketplace.

Now in its third edition, this year’s report features more detailed information on the reimbursement landscape for genetic tests, including an analysis of genetic testing claims across tens of millions of commercially insured members.

Sections include:

Market Size:
How many tests are currently on the market?

Market Growth:
How quickly is the US genetic testing market growing?

Exome Sequencing:
What’s the status of the clinical integration of whole exome sequencing?

Multi-Gene Panels:
What’s the status of multi-gene panels in the market?

Billing & Reimbursement:
What are the trends and challenges in reimbursement?

To download a copy of the report, please complete the form to the right.

The post The Current Landscape of Genetic Testing  – 2018 Edition appeared first on Concert.

Drawing on direct engagement with leading clinicians, hospitals, health plans, laboratories and governing organizations, as well as the most robust genetic diagnostics data on the market, this document describes the barriers faced by stakeholders across the system and specific steps to overcome those barriers.

This document addresses:

• What is the Genetic Health Information Network?
• What are the near term (2-3 year) opportunities to improve the clinical and economic value genetics brings to healthcare?
• How might a long-term, fully functional Genetic Health Information Network enable the healthcare system to deliver on the promise of precision medicine?

To instantly access the document, submit the form on this page.

The post Connecting the Genetic Health Information Network appeared first on Concert.

1. Market Size
There are almost 70,000 genetic testing products on the US market.

2. Market Growth
An average of approximately 10 new testing products enter the market every day, making it difficult for stakeholders across the healthcare system to manage the pace of change.

3. Next Generation Sequencing
Much of the growth in the market is attributable to NextGen Sequencing (NGS), which now accounts for an estimated 48% of the tests currently on the market.

4. Complexity and Variety
Testing options are becoming more complex, with laboratories packaging testing products in a widening variety of ways. BRCA1/2 , Exome and Non-invasive Prenatal Testing (NIPT), specifically, are available in increasing variety.

5. Clinical Workflow
Healthcare providers face mounting challenges integrating genetic testing into the clinical workflow. Utilization management tools, such as the Concert Platform, are helping institutions across the country address and overcome these challenges.

Submit the form on this page for instant access to the report.

The post The Current Landscape of Genetic Testing (2017 Update) appeared first on Concert.

Drawing on a database of more than 65,000 genetic testing products and experience analyzing the genetic testing claims of more than 100 million members, Concert Genetics brings unique insight to this subject. With this data-rich white paper you’ll have access to:

• New data on test pricing trends

• Insights into health plan payment experience

• Updates on clinical utility and medical policy considerations

To instantly access the report, submit the form on this page.

The post A Guide to BRCA Testing for Health Plans appeared first on Concert.

• Identify which codes are most commonly recommended by labs,

• Measure how frequently are tier 1, tier 2 and miscellaneous (81479) codes recommended for panel tests, and

• Highlight the implications of these findings.

To access this poster instantly, submit the form on this page.

The post An Analysis of Laboratory Billing Codes appeared first on Concert.

In this presentation, our colleague Lee Zellmer, MS, CGC, from Children’s Mercy Hospital discussed the results of a multifaceted utilization management program – one that includes the use of the GeneConnect platform. Reductions in cost-per-test are considerable.

To instantly access these slides, submit the form on this page.

The post Genetic Testing Utilization Management: A Children’s Hospital Perspective appeared first on Concert.

In this presentation, Dr. Jud Schneider discusses an analysis of the 2013 summary data set from CMS and the findings it reveals including:

• How much does CMS spend on laboratory services?
• What genes did CMS spend the most on?
• How do these payments align with test ordering guidelines?

The findings around the MTHFR gene are particularly interesting.

To access this presentation instantly, submit the form on this page.

The post Widespread Use of MTHFR and Other Genetic Testing in the Medicare Population appeared first on Concert.