- Optum is launching a new program to help insurers cut down on "unnecessary lab testing," a move it says will save insurers $3 billion annually.
- The program is intended to address the lack of oversight as new genetic tests enter the market, said Optum, a division of UnitedHealth Group, parent company to the nation's largest private insurer.
- The aim is to ensure physicians are guiding patients to tests that are clinically proven, avoiding unnecessary tests that can lead to incorrect results and unnecessary follow-up interventions, Optum said.
The move comes on the heels of a New York Times investigation that showed prenatal testing results are frequently wrong.
The newspaper analyzed results from five screening tests and found they were inaccurate between 81% and 93% of the time, leaving some expectant mothers to panic about the health of their unborn child, which resulted in more testing.
In April, the Food and Drug Administration warned the public about prenatal tests that screen for genetic abnormalities.
Even though the tests are widely used, they "have not been reviewed by the FDA and may be making claims about their performance and use that are not based on sound science,” Jeff Shuren, director of the FDA’s Center for Devices and Radiological Health, said in an April statement.
The increased use of these tests and lack of oversight is where Optum sees an opportunity.
“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," Jill Hagenkord, chief medical officer of Optum Genomics, said in a statement.
Optum says roughly 13 billion clinical lab tests are performed each year and 30% are unnecessary.
Laboratory operators could be challenged as Optum aims to crack down on testing.
Clinical laboratory chain Quest Diagnostics said that it’s committed to appropriate use of laboratory tests.
"We provide several solutions to help health plans and providers optimize laboratory test utilization, engage members in preventive care, and reduce costly out-of-network utilization," Quest said in a statement to Healthcare Dive.