The new solution will help health plans align lab testing with clinical guidelines to automate pieces of lab benefit administration. Through this offering, the UnitedHealth Group subsidiary says health plans could save $12 to $36 per member annually, or more than $3 billion, according to a June 22 news release.
Though 13 billion clinical lab tests occur annually and health plans spend billions on them, research has shown that 30 percent of lab tests are not needed and could even be harmful to patients. Optum cited the lack of industry standards and test management and oversight as the reason health plans need the solution
The solution also includes a multi-organizational team of clinical experts that will create evidence-based lab policies and evaluate new tests within the emerging genomics market.
“Testing is expanding so rapidly that most clinicians do not have the bandwidth to stay up-to-date on which ones are the highest quality. As clinicians, we all want reliable test results as we make decisions for our patients,” Jill Hagenkord, MD, chief medical officer at Optum Genomics, said. “This laboratory benefit management solution leverages deep clinical expertise to help guide clinicians to the tests with the highest clinical validity and utility.”
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