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Points of friction within health systems

Even before the paradigm shift to mainstream genetic screening, health systems were straining to meet the goals of improving patient experiences and population health while reducing cost. The increased demand for genetic screening throughout the reproductive journey has illuminated common challenges in 3 distinct areas within health systems. 

Despite global healthcare spending surpassing $8 trillion,1 there are still significant challenges in improving health outcomes. Currently, wasteful use of resources accounts for up to a quarter of healthcare spending globally.2

Case in point: a study revealed that 20% of adults reported tests being ordered that had already been done in the past 2 years,3 which potentially increases clinical risks and leads to wasted time and money spent complying with medical requests. In the US, measures to eliminate wasteful administrative spending alone could save up to $265 billion.4

A major step toward addressing these inefficiencies starts with more effective electronic health record systems (EHRs). In fact, nearly $600K was recently issued by the AMA to study how EHRs can be used to reduce stress and burnout, improve workflows, and boost value-based care.5

This effort will be significant, especially for health systems that are not fully integrating genetic screening into EHRs due to the complexity of testing information, referral recommendations, coordination of communication between providers and specialists, and post-test care pathways for patients identified with hereditary risk.6 This integration requires a special expertise that isn’t always inherent at health systems. 

A national survey found that 68% of participating organizations had many vacancies for geneticists and genetic counselors.7 These shortages, combined with the large volume of genetic tests available, contribute to uneasiness about test ordering, interpreting results, and selecting appropriate follow-up diagnostic tests. Misinterpretation of genetic results can have significant consequences, including incorrect diagnoses, unnecessary treatments and interventions, and increased stress on patients and their families.8

These data points paint the inauspicious picture well:

- There are 150,000 genetic tests on the market with approximately 10 new tests added daily,9 along with complicated coding policies, and thousands of pages of medical policy to interpret—all making it difficult for a health system to stay up to date

-  A recent survey showed that 83% of respondents reported that they were aware of at least 1 example of misinterpretation of a genetic testing result during their career.8

Although cost has decreased, out-of-pocket costs of genetic testing can range from $100 to $2,000 depending on the type of test that is ordered and how much is covered by insurance.6 While most state Medicaid programs cover NIPS for all pregnant women, there are some that only cover testing for high-risk women and some that do not cover it at all.10

Navigating coverage and preauthorization requirements is a significant administrative burden—in fact, an AMA survey reports that physicians complete an average of 41 prior authorizations per week, translating to almost 2 business days of physician and staff time.11

 

Let's reduce friction by consolidating testing with a specialized lab

Expertise in comprehensive genetics and women's health

With decades of experience in genetics and women's health, Quest is a trusted leader in the field. Our expertise extends beyond prenatal genetic screenings, allowing health systems to leverage our comprehensive genetics portfolio and test menu to drive personalized, proactive care throughout the pregnancy journey.

 

From preconception counseling to postnatal care, Quest is there every step of the way – starting with QHerit®, our carrier screening that provides clinically relevant results to help determine carrier risk for patients considering pregnancy. We also offer QNatal® Advanced, which is a low-risk, noninvasive prenatal screen, performed as early as 10 weeks into the pregnancy.

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Commitment to genetics expertise

In today's rapidly evolving healthcare landscape, staying ahead of the curve in prenatal genetics is essential to the patient and provider experience. By partnering with Quest, health systems can confidently rely on genetic expertise with consultation from our dedicated Genomic Client Services, ensuring optimal patient care and provider experience while navigating the complexities of prenatal genetic screening.

 

Health systems will also have access to the genomic specialists, genetic counselors, and biostatisticians among our 700 MDs and PhDs to consult and advise.

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Support services with IT and EHR integration

Quest understands the importance of accessible support services and seamless integration into complex EHR systems. Our dedicated team provides personalized support to patients throughout the testing process, ensuring they have the resources and assistance they need, as well as a high level of service from your Quest Account Representative. Quest seamlessly integrates with existing EHR and IT systems, minimizing disruptions and streamlining workflows, allowing ease of use for you and your systems.
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Accessible pricing and affordability 

Affordability can be key when extending the impact of genetic testing for health systems. Quest ensures competitive pricing for your system and your patients. We are in-network with all major insurers and offer specialized services to help with preauthorizations. Our Patient Navigators can help with billing questions, and we offer financial assistance programs for patients.

 

By partnering with Quest to consolidate prenatal genetic screening, health systems can achieve greater consistency, efficiency, and effectiveness, ultimately leading to better outcomes for patients and providers alike.

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Lets discuss your prenatal genetic screening needs.

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1. WHO. Global spending on health 2020: weathering the storm. December 10, 2020. Accessed June 23, 2023. https://www.who.int/publications/i/item/9789240017788

2. Organisation for Economic Co-operation and Development. Tackling Wasteful Spending on Health. OED Publishing. 2017. doi:10.1787/9789264266414-en. 

3. Hunter K, Kendall D, Ahmadi L. The case against fee-for-service health care. Third Way. September 9, 2021. Accessed June 23, 2023. https://www.thirdway.org/report/the-caseagainst-fee-for-service-health-care 

4. Sahni NR, Carrus B, Cutler DM. Administrative simplification and the potential for saving a quarter-trillion dollars in health care. JAMA. 2021;326(17):1677-1678. doi:10.1001/jama.2021.17315 

5. Wicklund E. AMA distributes grants to study EHR use. HealthLeaders. June 21, 2023. Accessed June 27, 2023. https://www.healthleadersmedia.com/technology/amadistributes-grants-study-ehr-use 

6. Dusic EJ, Theoryn T, Wang C, et al. Barriers, interventions, and recommendations: Improving the genetic testing landscape. Front Digit Health. 2022;4:961128. doi:10.3389/fdgth.2022.961128

7. Maiese DR, Keehn A, Lyon M, et al. Current conditions in medical genetics practice. Genet Med. 2019;21(8):1874-1877. doi:10.1038/s41436-018-0417-6 

8. Donohue KE, Gooch C, Katz A, et al. Pitfalls and challenges in genetic test interpretation: An exploration of genetic professionals experience with interpretation of results. Clin Genet. 2021;99(5):638-649. doi:10.1111/cge.13917

9. Phillips KA, Deverka PA, Hooker GW, et al. Genetic test availability and spending: Where are we now? Where are we going? Health Aff (Millwood). 2018;37(5):710-716. doi:10.1377/hlthaff.2017.1427

10. Coalition for Access to Prenatal Screening. Improve access to cfDNA-based noninvasive prenatal screening. Accessed June 26, 2023. https://capsprenatal.com/wp-content/uploads/2021/08/Improve_Access_to_NonInvasive_Prenatal_Screening_8.21.pdf

11. AMA. 2022 AMA prior authorization survey. Accessed July 3, 2023.https://www.ama-assn.org/system/files/prior-authorization-survey.pdf

 

 

 

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