Forty-four managed care organizations have licensed McKesson’s molecular and genetic diagnostic management solutions, including recent new health plan customers Molina Healthcare Inc, Paramount Healthcare, and Providence Health Plans, part of the five-state Providence Health & Services. These organizations are using McKesson offerings to help manage the growth, complexity, and costs associated with molecular and genetic testing.
McKesson’s molecular and genetic testing management solutions help health plans, ordering physicians, and clinical labs collaboratively manage molecular and genetic test utilization and associated medical costs by providing evidence-based decision support tools at the point of care.
“As Molina watches the continued growth of personalized medicine and genetic testing, we are excited about what these new developments mean for our members and for the way healthcare works,” said Michael M. Siegel, MD, VP of utilization management and quality improvement for Molina Healthcare. “However, the area of molecular diagnostics is a difficult one to manage because it’s evolving so quickly and there is a constant influx of new tests. We partnered with McKesson to help us manage utilization, and to understand the evidence to support this testing and keep us current as this area continues to grow. Furthermore, this assists us in our attempts to decrease the disparities in health outcomes in Medicaid populations; this resource will improve their care by providing timely information on the latest developments in genetic testing.”
McKesson’s molecular and genetic testing management offerings include InterQual® Molecular Diagnostic Criteria, Clear Coverage™, Clear Orders™, and specialized analytics services. This combination provides evidence-based clinical decision support for over 500 molecular and genetic tests—representing approximately 85% of all molecular diagnostics activity. The Clear Coverage and Clear Orders tools automate notifications and authorizations while giving providers access to medical, network and benefit policies, as well as validate coverage prior to testing and forwards orders to appropriate labs. InterQual Criteria, the leading clinical decision support content, are included in Clear Coverage to provide medical necessity guidelines based in the latest evidence-based medicine.
“We are thrilled with the market acceptance of our molecular diagnostics solutions among these managed care organizations and are seeing tremendous interest in our offerings,” said Matthew Zubiller , VP, decision management, McKesson Health Solutions. “Our managed care customers continue to look to McKesson to help them stay at the forefront of innovation, managing the explosive growth of molecular and genetic medicine and, most importantly, to make the best care decisions for their members.”
