Much of the $2 trillion spent annually within today's healthcare system is spent on inappropriate care and administration. If an accurate diagnosis can be reached faster, the inappropriate care that comes along with trial and error will diminish. Automating much of the decision-making process can further lower administrative costs. We can attack that 50% by connecting all involved parties with timely and useful information. Health plans can prepare for the shift toward ever-more personalized medicine by combining evidence-based content, decision-support technology (ideally at the point of care), prospective, exception-based authorization technology and analytic services.
The role of managed care in precision medicine is not to reduce the use of all tests. Rather it is to optimize the use of diagnostics, taking into consideration the total cost of care. Plans would not want to deny a $200 test that could reveal that Patient X will not respond to an $80,000 drug – and a patient certainly does not want to waste valuable time on a treatment that could do more harm than good. A successful program makes all information available and transparent to all parties to speed optimal decision-making. It also gathers a rich, data set that can be further extended and drive the analytics for future planning.
Medical science is rapidly developing better genetic-level tools to accurately diagnose and treat disease. Used well, the new paradigm of precision medicine has great potential for eliminating the trial and error that is one of the greatest drains on the healthcare economy.
Matthew Zubiller is vice president of advanced diagnostic management at McKesson Health Solutions. He can be reached via email at firstname.lastname@example.org