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For many health plans, genetic testing feels like a moving target. The landscape of laboratories, tests, coding, evidence, and guidelines is changing too rapidly to confidently manage. Meanwhile, the lack of clear data on quality and accuracy makes it difficult to recognize and reward labs offering high-value testing.
From the lab perspective, standing out in a crowded market can be equally challenging. Even the best labs have trouble differentiating their tests, while unsafe and even fraudulent labs operate in the shadows putting patients at risk.
In response to these challenges, some health plans are taking innovative steps. Leading plans are collecting quality information beyond CLIA certification and CAP accreditation, even requiring third-party validation of test accuracy. To manage costs and streamline operations, plans are requiring transparency up-front into how tests will be coded and billed. Steps like these are enabling more testing to be performed at high-quality labs at consistent rates.
In this webinar, health plan leaders will discuss how they are approaching this complex space, and what more is needed to improve quality and experience for members.
Matt Fickie, MD
Senior Medical Director for Medical Policy
Dr. Matt Fickie is Senior Medical Director for Medical Policy at Highmark. As the plan’s internal expert on precision medicine, Dr. Fickie focus has been on advancing the use of genetic technologies to improve health outcomes. He oversees Highmark’s Medical Policy Department which includes Highmark’s innovative Coverage with Evidence Determination program. He is also a member of the Highmark team that led the implementation of the plan’s requirement for third-party validation on NGS panels from in-network laboratories. Prior to joining Highmark, he served as an attending physician at Mount Auburn Hospital in Cambridge, MA. Dr. Fickie is board certified in internal medicine, general pediatrics, and clinical genetics.
Troy Dickinson, MBA
Principal Clinical Research Analyst-Affordability
Blue Cross and Blue Shield of Minnesota
Troy Dickinson is a Principal Clinical Research Analyst at Blue Cross and Blue Shield of Minnesota. He has served in various roles at Blue Cross throughout his 21 year career. He has been in his current role on the Affordability and Population Health team for the past 7 years focusing on ways to make healthcare more affordable.
Christy Moore, MS, CGC
Clinical Genetics Program Manager
Blue Shield of California
Christy Moore is a genetic counselor and currently manages the Genetics Program at Blue Shield of California. She has experience in prenatal and pediatric genetics, with a focus on rare disease. Prior to her current role, she has held positions in clinics, a hospital, a commercial genetic lab, and public health. She holds an MS in Human Genetics from UC Davis, and an MS in Genetic Counseling from UC Irvine.