Cancer Genomics Testing: diagnostic yield and reimbursement
|
|
- Laura Bruce
- 5 years ago
- Views:
Transcription
1 Cancer Genomics Testing: diagnostic yield and reimbursement Anthony N. Sireci, MD, MS Assistant Professor of Pathology and Cell Biology Columbia University Medical Center Assistant Director and Physician Manager Laboratory of Personalized Genomic Medicine
2 Outline Review of cancer genomics test menu and requirements for complex workflow Analysis of utilization of genomics testing over time at CUMC Overview of diagnostic yield for comprehensive cancer panel Reimbursement experience Future directions
3 Executive Summary The introduction and deployment of NGS-based genomics testing in oncology requires building a complex, inter-departmentally aligned ecosystem that is distinct from more routine laboratory testing Oncologists and patients alike are driving the increased utilization of genomic oncology testing at rates which exceed the growth of more standard molecular oncology diagnostics Our experience at CUMC shows that large cancer panels and whole exome testing identify targetable/actionable/impactful mutations at a high rate and at least suggest clinical effectiveness of this testing Reimbursement from third party payers does not meet costs for the majority of genomics testing and is trending downward on a month by month basis. Poor reimbursement is mainly driven, in cancer panels, by Medicare and a select private payer Our team is working on a variety of mechanisms to increase oncologist involvement in appropriate test utilization as well as working with oncologists to establish convincing costeffectiveness models
4 Outline Review of Cancer genomics test menu and requirements for complex workflow Analysis of utilization of genomics testing over time at CUMC Overview of diagnostic yield for comprehensive cancer panel Reimbursement experience Future directions
5 We have developed and validated a tiered approach to NGS oncology testing at CUMC and have provided this testing since July, genes commonly associated with cancer Histologyspecific panels TruSeq Cancer Panel Columbia Combined Cancer Panel (CCCP) 467 cancer-related genes selected by CUMC oncologists 393 exon-only genes and 74 select whole genes (FM: 236 exons; 19 rearrangements) Micro-dissection to enrich for tumor content; lower requirements than FM Cancer Whole Exome with Transcriptome (cwes) Tumor exome, germline exome, and transcriptome Provides information on: cancer predispositions somatic mutations copy number changes translocations expression data
6 Clinical traige Of variants Data DNA Cancer genomics testing requires establishing a workflow which goes beyond the traditional focus of the molecular pathology laboratory Assesses tumor cellularity Micro/macrodissection Microdissection Macrodissection DNA extraction Molecular accessioning H&E Molecular Pathologist NGS Feedback Internal consensus Clinical Report Bioinformatics LIS Report EHR
7 Clinical traige Of variants Data DNA Even within the more traditional workflows, there are unique challenges when deploying cancer genomics testing Assesses tumor cellularity Micro/macrodissection Microdissection Macrodissection DNA extraction Molecular accessioning H&E Molecular Pathologist NGS Feedback Internal consensus Clinical Report Bioinformatics LIS Report EHR
8 CPT codes Submit CPT Codes for preauth diagnosis Patient/test information Clinical traige Of variants Data tissue DNA However, cancer genomics testing requires establishing a workflow to integrate oncologists, anatomic pathologists, the EMR, the molecular lab and third party payers Rad/onc Patient with possible cancer Surgery Assesses tumor cellularity Micro/macrodissection Microdissection Macrodissection DNA extraction Pathology Assess adequacy Choose block H&E and blanks Molecular accessioning H&E Molecular Pathologist NGS Oncologist Cancer Panel order Preauth granted Billing Preauth Feedback Internal consensus Clinical Report Bioinformatics Preauth decision LIS 3 rd party payer Report Billing system EHR Molecular Pathology Report
9 CPT codes Submit CPT Codes for preauth diagnosis Patient/test information Clinical traige Of variants Data tissue DNA Cancer genomics testing requires establishing a workflow to integrate oncologists, anatomic pathologists, EMR, the molecular lab and third party payers refocus! Rad/onc Patient with possible cancer Surgery Assesses tumor cellularity Micro/macrodissection Microdissection Macrodissection DNA extraction Pathology Assess adequacy Choose block H&E and blanks Molecular accessioning H&E Molecular Pathologist NGS Oncologist Cancer Panel order Preauth granted Billing Preauth Feedback Internal consensus Clinical Report Bioinformatics Preauth decision LIS 3 rd party payer Report Billing system EHR Molecular Pathology Report
10 CPT codes Submit CPT Codes for preauth diagnosis Patient/test information Clinical traige Of variants Data tissue DNA Cancer genomics testing requires establishing a workflow to integrate oncologists, anatomic pathologists, the molecular lab and third party payers accounting for reflex Rad/onc Patient with possible cancer Surgery Assesses tumor cellularity Micro/macrodissection Microdissection Macrodissection DNA extraction Pathology Assess adequacy Choose block H&E and blanks Molecular accessioning H&E Molecular Pathologist NGS Oncologist Cancer Panel order Preauth granted Billing Preauth Feedback Internal consensus Clinical Report Bioinformatics Preauth decision LIS 3 rd party payer Report Billing system EHR Molecular Pathology Report
11 CPT codes diagnosis Clinical traige Of variants Data tissue DNA Cancer genomics testing requires establishing a workflow to integrate oncologists, anatomic pathologists, the molecular lab and third party payers accounting for reflex Rad/onc Patient with possible cancer Surgery Assesses tumor cellularity Micro/macrodissection Microdissection Macrodissection DNA extraction Pathology Assess adequacy Choose block H&E and blanks Molecular accessioning H&E Molecular Pathologist NGS Feedback Bioinformatics Oncologist Internal consensus Clinical Report LIS 3 rd party payer Report Billing system EHR Molecular Pathology Report
12 Outline Review of cancer genomics test menu and requirements for complex workflow Analysis of utilization of genomics testing over time at CUMC Overview of diagnostic yield for comprehensive cancer panel Reimbursement experience Future directions
13 Specimen count There has been a 8% (range: 4-13%) month over month increase in the utilization of histology-specific targeted cancer panels at CUMC 40 Utilization of histology-specific cancer panels (Jan 2015-Jul 2016) LUNG PANEL COLORECTAL PANEL MELANOMA PANEL TSEQ PANEL
14 Specimen count There has been a 10.4% and 2% month over month increase in the utilization of comprehensive panels and cwes, respectively at CUMC 60 Utilization of large cancer panels and whole exome/transcriptome (Jan July 2016) CCCP cwes
15 Specimen count This trend in increased utilization has not been seen in a more standard molecular assay testing TCR clonality 80 Utilization: TCR assay (Jan 2015-July 2016 )
16 Ordering practices differ by test ordered with Lung and Colorectal panels being ordered mostly on inpatients 70% Cases ordered on inpatients % of total 60% 50% 40% 30% 20% 10% 0% CCCP LUNG PANEL COLORECTAL PANEL MELANOMA PANEL TRUSEQ
17 Outline Review of cancer genomics test menu and requirement for complex workflow Analysis of utilization of genomics testing over time at CUMC Overview of diagnostic yield for comprehensive cancer panel Reimbursement experience Future directions
18 We are able to successfully sequence the majority of specimen submitted to the laboratory including biopsies and FNA samples Sireci et. al. Data in submission for publication
19 Sireci et. al. Data in submission for publication
20 Our large cancer panel has a diagnostic hit rate of ~50% and is particularly effective for certain cancers Sireci et. al. Data in submission for publication
21 Our large cancer panel has a diagnostic hit rate of ~50% of cases and is particularly effective for certain cancers Sireci et. al. Data in submission for publication
22 Outline Cancer genomics test menu and requirement for complex workflow Analysis of utilization of genomics testing over time at CUMC Overview of diagnostic yield for comprehensive cancer panel Reimbursement experience Future directions
23 % of costs reimbursed While the lung panel is reimbursed at a breakeven value, the remainder of our cancer genomics assays are performed at a loss/sample 120% Average reimbursement of cancer genomics testing % of estimated cost (Jan 2015-July 2016) 100% 80% 60% 40% 20% 0% cwes CCCP Lung Panel Colorectal Panel Melanoma Panel TruSeq
24 We observe similar trends in reimbursement over time for histology-specific subpanels for lung and colorectal cancers, each decreasing 4% and 5% respectively monthly Reimbursement Reimbursement over time for the most commonly ordered subpanels Lung Colorectal
25 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Tests ordered per month Reimbursement Analysis of reimbursement over time for shows a month over month decrease in payments while utilization by oncologists is increasing Utilization for over time Average reimbursement for over time
26 Reimbursement for cwes has seen a modest month over month increase of 2% since January 2015 and might be the consequence of a unique payer mix in Pediatrics Total reimbursed per case Reimbursement over time for cwes
27 % of costs reimbursed A deeper dive into reimbursement for our comprehensive cancer panel coded under during 2015 reveals causes of low reimbursement including payer mix, ICD10 codes used and payer classification of genomics testing as non-clinical 120% Average reimbursement of cancer genomics testing % of estimated cost 100% 80% 60% 40% 20% 0% cwes CCCP Lung Panel Colorectal Panel Melanoma Panel TruSeq
28 A deeper dive into reimbursement for large panel testing (>51 genes) in 2015 shows low reimbursement relative to EGFR CPT code driven mainly by 0% payment by Medicare Distribution of payers for CCCP cases (n=153) Reimbursement by payer for % Commercial Government Managed Gov't 40% 35% 30% 30% 52% Average reimbursement as a percent off charges for % 20% 15% 10% Mean=19.4% Commercial Government Managed Gov't 5% 0% Commercial Government Managed Gov't Distribution of payers for EGFR cases (n=231) Reimbursement by payer for % 21% 42% 37% Commercial Government Managed Gov't Average reimbursement as a percent off charges for % 40% 35% 30% 25% 20% 15% 10% 5% 0% Mean=36.8% Commercial Government Managed Gov't Commercial Government Managed Gov't Sireci et. al. Data in submission for publication
29 Insurers appear to be more likely to pay for comprehensive sequencing for certain tumor types over others, but this analysis is complicated by differences in payer mix Average reimbursement by histology Payer mix by organ system involved Average reimbursement as a percent of charges for % 30% 25% 20% 15% 10% 5% 0% Mean=20.4% Liver GU Bone and soft tissue CUP Breast Gyn GI Colon Pancreas Lung Other Melanoma CNS Heme commercial Government Managed Gov't Other Sireci et. al. Data in submission for publication
30 Despite an 82% approval of preauthorization for 81455, we maintain a high denial rate for this code relative to more standard codes Payment and denial rates CCCP (81455) 100% n=153 80% 45% Denied 60% Reimbursed Summary of major of denial reasons CCCP (81455) 100% 80% 60% 5% 13% Noncovered service No authorization Clinical notes required 40% 20% 55% 40% 20% 82% 0% Cases with available reimbursement data 0% Denied cases Payment and denial rates EGFR (81235) 100% 80% 60% 40% 20% 0% n=231 86% 14% Cases with available reimbursement data Denied Reimbursed Summary of major of denial reasons EGFR (81235) 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 16% 34% 50% Denied cases Noncovered service Clincial notes required Other Sireci et. al. Data in submission for publication
31 Outline Cancer genomics test menu and requirement for complex workflow Analysis of utilization of genomics testing over time at CUMC Overview of diagnostic yield for comprehensive cancer panel Reimbursement experience Future directions
32 Future Directions Studies evaluating the cost and cost-effectiveness of cancer whole exomes in pediatrics and cancer panel testing compared to standard diagnostics in progress Working with third party payers to establish more favorable reimbursement policies for this testing in progress Developing clinical utilization strategies and protocols to focus this costly testing on the correct patient population in progress Establishing a streamlined workflow for involvement of CGC members to add to LCD responses from AMP/CAP plea Publication of collective reimbursement experience by CGC members recent idea (like, last night)
33 Acknowledgments Administrators Melissa Carter Kris Smith Joann Li Medical Directors Mahesh Mansukhani Brynn Levy Susan Hsiao Vimla Aggarwal Andrew Turk Tatyana Gindin Clinicians Andrew Kung Rich Carvajal Julia Glade Bender Jennifer Oberg Technical Staff Vaishali Hodel Odelia Nahum
Sleep Market Panel. Results for June 2015
Sleep Market Panel Results for June 2015 Notes: o This is a monthly trending report of panel member data along with additional analysis by: Sleep labs affiliated with Hospitals vs. Independent Labs o Hospital
More informationAn Updated Approach to Colon Cancer Screening and Prevention
An Updated Approach to Colon Cancer Screening and Prevention Kevin Liebovich, MD Director for Quality for Gastrointestinal diseases Advocate Condell Medical Center Colon Cancer Screening and Prevention
More informationImportance of Methodology Certification and Accreditations to Perform Assays. Stan Hamilton, MD Head, Pathology and Laboratory Medicine
Importance of Methodology Certification and Accreditations to Perform Assays Stan Hamilton, MD Head, Pathology and Laboratory Medicine 1 Disclosures No disclosures relevant to this presentation 2 A bad
More informationGenetic testing for hereditary cancer. An overview for healthcare providers
Genetic testing for hereditary cancer An overview for healthcare providers Specimen requirements Whole blood Two 4.5 ml EDTA tubes (lavender top) Please wait at least 2 weeks after a packed cell/platelet
More informationMolecular Diagnostics Overview JAN A. NOWAK, PHD, MD PATHOLOGY AND LABORATORY MEDICINE MOLECULAR DIAGNOSTICS LABORATORY FEBRUARY 15, 2018
Molecular Diagnostics Overview JAN A. NOWAK, PHD, MD PATHOLOGY AND LABORATORY MEDICINE MOLECULAR DIAGNOSTICS LABORATORY FEBRUARY 15, 2018 Some Key Points Molecular Testing has applications in every section
More informationAre Payers Getting Tougher? Essential Insights on How to Smooth Acceptance of New Genetic Tests
Are Payers Getting Tougher? Essential Insights on How to Smooth Acceptance of New Genetic Tests Jacqueline Huang Senior Associate Reimbursement Policy and Government Affairs Objectives Learn how payers
More informationComplete Central Registry Treatment Information Requires Ongoing Reporting and Consolidation Well Beyond 6-Month Reporting
Complete Central Registry Treatment Information Requires Ongoing Reporting and Consolidation Well Beyond 6-Month Reporting Eric B. Durbin, DrPH, MS, Director of Cancer Informatics Frances E. Ross, CTR,
More informationPreanalytic Variables in Cytology: Lessons Learned from Next Generation Sequencing
@Sinchita_Roy #USCAP2017 #PulmPath #IAmUSCAP #insitupathologists Preanalytic Variables in Cytology: Lessons Learned from Next Generation Sequencing Sinchita Roy-Chowdhuri, MD, PhD Department of Pathology
More informationMICHIGAN PATHOLOGY QUALITY SYSTEM (MPQS)
MICHIGAN PATHOLOGY QUALITY SYSTEM (MPQS) Divisions of Anatomic Pathology & Clinical Informatics, Department of Pathology Administrative Forum December 15, 2008 Anatomic Pathology An Introduction 81 staff
More informationEmergency Department Boarding of Psychiatric Patients in Oregon
College of Public Health and Human Sciences Emergency Department Boarding of Psychiatric Patients in Oregon Jangho Yoon, PhD, Jeff Luck, PhD April 25, 2017 Scope Quantify the extent of psychiatric emergency
More informationSession #206, March 8, 2018 Susan J. Kressly, MD, FAAP, Kressly Pediatrics Dr. Jacques Orces, D.O., Nicklaus Children s Hospital
Improving Preventative Care in Pediatrics through Health and Technology: A Davies Story Session #206, March 8, 2018 Susan J. Kressly, MD, FAAP, Kressly Pediatrics Dr. Jacques Orces, D.O., Nicklaus Children
More informationThe Third-Party Reimbursement Process for Orthotics
The Third-Party Reimbursement Process for Orthotics When the foot hits the ground, everything changes. We know that over 90% of the population suffers with overpronation of their feet. Implementing Foot
More informationMolecular Testing Updates. Karen Rasmussen, PhD, FACMG Clinical Molecular Genetics Spectrum Medical Group, Pathology Division Portland, Maine
Molecular Testing Updates Karen Rasmussen, PhD, FACMG Clinical Molecular Genetics Spectrum Medical Group, Pathology Division Portland, Maine Keeping Up with Predictive Molecular Testing in Oncology: Technical
More informationOne Palliative Care Annual Report
One 203 Palliative Care Annual Report One In 202, ASCO released a provisional clinical opinion stating that concurrent palliative care should be considered early in the course of advanced or metastatic
More informationAlignment Strategies at the JPS Health Network
Improving the Patient Experience Alignment Strategies at the JPS Health Network JPS HEALTH NETWORK 537 bed hospital, Level 1 Trauma Center Tarrant County s Safety Net Hospital 15 primary care clinics 20
More informationUrinary Catheters Do Not Have to Be Removed if They Were Never Placed
Urinary Catheters Do Not Have to Be Removed if They Were Never Placed A formal performance improvement project to decrease utilization of urinary catheters in surgical patients A. D. Yang 1,2,3, M. W.
More information18 Week 92% Open Pathway Recovery Plan and Backlog Clearance
18 Week 92% Open Pathway Recovery Plan and Backlog Clearance Page 1 of 6 17.05.2012 1.0 Background 18-Week 92% Open Pathway RECOVERY PLAN The Trust has achieved compliance against the admitted and non-admitted
More informationRegulatory Landscape for Precision Medicine
Regulatory Landscape for Precision Medicine Adam C. Berger, Ph.D. Office of In Vitro Diagnostics and Radiological Health, FDA FOCR-Alexandria A Blueprint for Breakthrough Meeting September 13, 2017 1 What
More informationMEDICAL POLICY. SUBJECT: MOLECULAR PANEL TESTING OF CANCERS TO IDENTIFY TARGETED THERAPIES (Excluding NSCLC and CRC) EFFECTIVE DATE: 12/21/17
MEDICAL POLICY SUBJECT: MOLECULAR PANEL TESTING OF PAGE: 1 OF: 5 If a product excludes coverage for a service, it is not covered, and medical policy criteria do not apply. If a commercial product, including
More informationNGS Gateway Lab Services
TM NGS Gateway Lab Services Accelerating Precision Medicine Design a Complete Genomic Testing Portfolio with Turnkey Assays About NGS Gateway Lab Services TM Designed to provide a gateway to your own in-house
More informationSupplementary Tables. Supplementary Figures
Supplementary Files for Zehir, Benayed et al. Mutational Landscape of Metastatic Cancer Revealed from Prospective Clinical Sequencing of 10,000 Patients Supplementary Tables Supplementary Table 1: Sample
More informationMonitoring Protocol for Clozapine-induced Myocarditis. Copyright 2017, CAMH
1 Monitoring Protocol for Clozapine-induced Myocarditis 1 Agenda Problem Identification / Identification Importance / Importance Baseline Workflow Baseline Workflow Baseline Data Baseline Data Objectives
More informationBreakthroughs in Quality: Improving Patient Care in Wisconsin
Breakthroughs in Quality: Improving Patient Care in Wisconsin Wisconsin Collaborative for Healthcare Quality Cindy Schlough Director of Strategic Partnerships Wisconsin Collaborative for Healthcare Quality
More informationFlu Watch. MMWR Week 3: January 14 to January 20, and Deaths. Virologic Surveillance. Influenza-Like Illness Surveillance
Flu Watch MMWR Week 3: January 14 to January 2, 218 All data are provisional and subject to change as more reports are received. Geographic Spread South Carolina reported widespread activity this week.
More informationMolecular Methods in the Diagnosis and Prognostication of Melanoma: Pros & Cons
Molecular Methods in the Diagnosis and Prognostication of Melanoma: Pros & Cons Ben J. Friedman, MD Senior Staff Physician Department of Dermatology Department of Pathology and Laboratory Medicine Henry
More informationQuit Rates of New York State Smokers
Quit Rates of New York State Smokers Sara M. Abrams, MPH Data Manager NYS Smokers Quitline Sara.Abrams@roswellpark.org September 6, 20 Presentation Outline Basic Quitline Service How Quit Rates are defined
More informationSpring Understanding the potential of generic substitution
Spring 2014 Understanding the potential of generic substitution Understanding the potential of generic substitution Generic pricing reforms and the availability of generics for blockbuster drugs coming
More informationUnderstanding the Role of Palliative Care in the Treatment of Cancer Patients
Understanding the Role of Palliative Care in the Treatment of Cancer Patients Palliative care is derived from the Latin word palliare, to cloak. This is a form of medical care or treatment that concentrates
More informationEXAMPLE. - Potentially responsive to PI3K/mTOR and MEK combination therapy or mtor/mek and PKC combination therapy. ratio (%)
Dr Kate Goodhealth Goodhealth Medical Clinic 123 Address Road SUBURBTOWN NSW 2000 Melanie Citizen Referring Doctor Your ref Address Dr John Medico 123 Main Street, SUBURBTOWN NSW 2000 Phone 02 9999 9999
More informationFlu Watch. MMWR Week 4: January 21 to January 27, and Deaths. Virologic Surveillance. Influenza-Like Illness Surveillance
Flu Watch MMWR Week 4: January 21 to January 27, 218 All data are provisional and subject to change as more reports are received. Geographic Spread South Carolina reported widespread activity this week.
More informationColorado State Innovation Model (SIM) Clinical Quality Measures (CQMs) Reporting Schedules
Colorado State Innovation Model (SIM) Clinical Quality Measures (CQMs) Reporting Schedules 1 SIM Clinical Quality Measure (CQM) Reporting Schedules: Cohort 3 Table of Contents Reporting Schedules... 3
More informationReducing Readmissions and Improving Outcomes at OhioHealth Mansfield Hospital:
Reducing Readmissions and Improving Outcomes at OhioHealth Mansfield Hospital: Eugenio H. Zabaleta, Ph.D. Clinical Chemist OhioHealth Mansfield Hospital Reducing Readmissions and Improving Outcomes at
More informationKansas EMS Naloxone (Narcan) Administration
Kansas EMS Naloxone (Narcan) Administration Executive Summary Kansas Board of Emergency Medical Services August 217 The following pages denote an ongoing trending of naloxone administration by Kansas Emergency
More informationSuccessful Falls Prevention in Aged Persons Mental Health. Reducing the risk and decreasing severity of outcome
Successful Falls Prevention in Aged Persons Mental Health Reducing the risk and decreasing severity of outcome Vahitha Koshy Seema Dua Elda Kimberlee Introduction Unit 3- Acute Aged Mental Health inpatient
More informationTaking Laboratory Coding for a Spin. Corrie Alvarez, CPC, CPMA, CPC-I, CEDC
Taking Laboratory Coding for a Spin Corrie Alvarez, CPC, CPMA, CPC-I, CEDC Agenda Overview of Laboratory Discuss Common Laboratory Terms Coding Guidelines Review Drug Testing, Anatomical Pathology Discuss
More informationCincinnati Children s Hospital Medical Center PHO/OVPCA Constipation Initiative Monthly Report February 2018
Cincinnati Children s Hospital Medical Center PHO/OVPCA Constipation Initiative Monthly Report February 2018 Aim: Project focus to embed evidence based protocol for the treatment of Constipation in the
More informationNotification for Outpatient Injectable Chemotherapy for Medicare Advantage Plans Frequently Asked Questions
Notification for Outpatient Injectable Chemotherapy for Medicare Advantage Plans Frequently Asked Questions Key Points Physicians and facilities are required to submit notification to UnitedHealthcare
More informationUCL-Advanced Diagnostics. 2015/16 Service Update
UCL-Advanced Diagnostics 2015/16 Service Update About UCL-Advanced Diagnostics UCL Advanced Diagnostics (UCL-AD) is the immunohistochemistry, in situ and molecular diagnostics service arm of the UCL-Cancer
More informationYES. If yes, indicate what types of tumors/polyps and age of onset:
REQUEST FOR FAMILIAL ADENOMATOUS POLYPOSIS (FAP) TESTING Please provide the following information. We cannot perform your test without ALL of this information. PLEASE PRINT ALL ANSWERS PATIENT INFORMATION
More informationGetting Tissue for Molecular Testing: An NSCLC Strategic Initiative
Getting Tissue for Molecular Testing: An NSCLC Strategic Initiative Activity Summary Date: Jan, 2015 CME Credit Provider: Temple University School of Medicine Collaborators: Association of Community Cancer
More informationOncology Clinical Pathways: Making Treatment Decisions in the Era of Patient-Centered, Personalized Cancer Care June 12, 2017
Oncology Clinical Pathways: Making Treatment Decisions in the Era of Patient-Centered, Personalized Cancer Care June 12, 2017 Moderator: Daryl Pritchard, Ph.D. Vice President, Science Policy Personalized
More informationOverview of Health IT in Massachusetts: Data to Inform and Improve Performance
Overview of Health IT in Massachusetts: Data to Inform and Improve Performance Office of Economic Analysis, Evaluation and Modeling & State HIE Program December 2011 Chartpack Team Office of Economic Analysis,
More information2018 Edition The Current Landscape of Genetic Testing
2018 Edition The Current Landscape of Genetic Testing Market growth, reimbursement trends, challenges and opportunities November April 20182017 EXECUTIVE SUMMARY Concert Genetics is a software and managed
More informationMcLean ebasis plus TM
McLean ebasis plus TM Sample Hospital (0000) Report For Qtr HBIPS Core Measures McLean Hospital 115 Mill Street Belmont, MA 02478 1 2012 Department of Mental Health Services Evaluation Tel: 617-855-3797
More informationAugust 17, Dear Valued Client:
August 7, 08 Re: CMS Announces 6-Month Period of Enforcement Discretion for Laboratory Date of Service Exception Policy Under the Medicare Clinical Laboratory Fee Schedule (the 4 Day Rule ) Dear Valued
More informationColorectal Cancer- QI process and clinic success: A Case Study at Atascosa Health Center
Colorectal Cancer- QI process and clinic success: A Case Study at Atascosa Health Center Kaela Momtselidze Health Systems Manager Primary Care Systems American Cancer Society Sheri Frank Director of Corporate
More informationSeptember 23, The Role of In Vitro Diagnostic Tests in Pediatric Master Protocol Development
The Role of In Vitro Diagnostic Tests in Pediatric Master Protocol Development September 23, 2016 Anand Pathak, MD, PhD, MPH Medical Officer Molecular Genetics Branch Division of Molecular Genetics and
More informationImplementation of nation-wide molecular testing in oncology in the French Health care system : quality assurance issues & challenges
Implementation of nation-wide molecular testing in oncology in the French Health care system : quality assurance issues & challenges Frédérique Nowak - 21 october 2015 "Putting Science into Standards event:
More informationOverview of the Radiation Exposure Doses of the Workers at Fukushima Daiichi Nuclear Power Station
Click here for the corrections made < Reference > December 3, 212 Tokyo Electric Power Company Overview of the Radiation Exposure Doses of the Workers at Fukushima Daiichi Nuclear Power Station * As of
More informationFGSZ Zrt. from 28 February 2019 till 29 February 2020 AUCTION CALENDAR: YEARLY YEARLY BUNDLED AT CROSS BORDER POINTS
AUCTION CALENDAR: YEARLY YEARLY BUNDLED AT CROSS BORDER POINTS FIRM CAPACITY - First Monday of July 01.06.2019* 01.07.2019 07:00 01.10.2019 04:00 01.10.2020 04:00 2019/2020 01.10.2020 04:00 01.10.2021
More informationPatient Leader Education Summit. Precision Medicine: Today and Tomorrow March 31, 2017
Patient Leader Education Summit Precision Medicine: Today and Tomorrow March 31, 2017 Precision Medicine: Presentation Outline Agenda What is a Precision Medicine What is its clinical value Overview of
More informationTri-County Opioid Safety Coalition Data Brief December 2017 Clackamas, Multnomah, and Washington Counties
Medicaid-Funded Alternative Treatment for Back Pain in the Tri-County Region Key Findings The percentage of members with a back pain diagnosis who received an alternative treatment increased from 29% in
More informationAttracting Talent & Driving Growth in Wisconsin
Attracting Talent & Driving Growth in Wisconsin v 2 nd Annual Future Wisconsin Economic Summit Kevin Conroy, Chairman & CEO December 9, 2015 WMC Foundation: Second Annual Future Wisconsin Economic Summit
More informationIOWA MEDICAID DRUG UTILIZATION REVIEW COMMISSION 100 Army Post Road Des Moines, IA (515) Fax
IOWA MEDICAID DRUG UTILIZATION REVIEW COMMISSION 100 Army Post Road Des Moines, IA 50315 (515) 974-3131 Fax 1-866-626-0216 Brett Faine, Pharm.D. Larry Ambroson, R.Ph. Casey Clor, M.D. Mark Graber, M.D.,
More informationPersonalised cancer care Information for Medical Specialists. A new way to unlock treatment options for your patients
Personalised cancer care Information for Medical Specialists A new way to unlock treatment options for your patients Contents Optimised for clinical benefit 4 Development history 4 Full FIND IT panel vs
More informationClostridium difficile (C. difficile) and Staphylococcus aureus bacteraemia (MRSA and MSSA) Bi-annual Report. Surveillance: Report:
Surveillance: Report: Clostridium difficile (C. difficile) and Staphylococcus aureus ( and ) Bi-annual Report Time period: 1 st April to 30 th September 2016 Health Board: Wales Content: Issued by: Pg
More informationFAQs about Provider Profiles on Breast Cancer Screenings (Mammography) Q: Who receives a profile on breast cancer screenings (mammograms)?
FAQs about Provider Profiles on Breast Cancer Screenings (Mammography) Q: Who receives a profile on breast cancer screenings (mammograms)? A: We send letters and/or profiles to PCPs with female members
More informationNGS in Cancer Pathology After the Microscope: From Nucleic Acid to Interpretation
NGS in Cancer Pathology After the Microscope: From Nucleic Acid to Interpretation Michael R. Rossi, PhD, FACMG Assistant Professor Division of Cancer Biology, Department of Radiation Oncology Department
More informationDecember 13, The Future Reimbursement Environment for NGS for Oncology
WELCOME! Today s Speaker Mr. Mathews has worked on a variety of diagnostic reimbursement projects involving the analysis, development, and implementation of coding, coverage, and payment strategies for
More informationPRECISION INSIGHTS. GPS Cancer. Molecular Insights You Can Rely On. Tumor-normal sequencing of DNA + RNA expression.
PRECISION INSIGHTS GPS Cancer Molecular Insights You Can Rely On Tumor-normal sequencing of DNA + RNA expression www.nanthealth.com Cancer Care is Evolving Oncologists use all the information available
More informationNORTHERN HEALTH AND SOCIAL CARE TRUST. Waiting Times Summary Report
NORTHERN HEALTH AND SOCIAL CARE TRUST Waiting Times Summary Report April 2014 1 Waiting Times The Northern Health & Social Care Trust monitors waiting time performance against a number of Departmental
More informationNavigating Immuno-Oncology Coverage & Reimbursement Issues
Navigating Immuno-Oncology Coverage & Reimbursement Issues Niesha Griffith, RPh, MS, FASHP Administrator of Oncology Pharmacy and Infusion Services at the Arthur G. James Cancer Hospital and Richard J.
More informationMr. Glenn McGuirk Centers for Medicare and Medicaid Services 7500 Security Boulevard Baltimore, MD 21244
August 6, 2018 Mr. Glenn McGuirk Centers for Medicare and Medicaid Services 7500 Security Boulevard Baltimore, MD 21244 Submitted via email: glenn.mcguirk@cms.hhs.gov Dear Mr. McGuirk, The American Clinical
More informationNon-Profit Startup Paradigm Launches Cancer Panel Based on DNA, RNA Sequencing
Non-Profit Startup Paradigm Launches Cancer Panel Based on DNA, RNA Sequencing April 11, 2014 By Tony Fong Non-profit diagnostics outfit Paradigm last month joined a growing list of entrants in the clinical
More informationThe Infection Control Doctor and Clostridium difficile infection. Dr David R Jenkins University Hospitals of Leicester NHS Trust, England
The Infection Control Doctor and Clostridium difficile infection Dr David R Jenkins University Hospitals of Leicester NHS Trust, England 250 200 150 100 50 0 Monthly cases of Clostridium difficile (UHL
More informationPrecision Genetic Testing in Cancer Treatment and Prognosis
Precision Genetic Testing in Cancer Treatment and Prognosis Deborah Cragun, PhD, MS, CGC Genetic Counseling Graduate Program Director University of South Florida Case #1 Diana is a 47 year old cancer patient
More informationMolecular Tes,ng on Cytology Specimens
Molecular Tes,ng on Cytology Specimens Sco6 Boerner MD FRCPC Medical Director & Head of Cytopathology University Health Network Associate Professor, University of Toronto sco6.boerner@uhn.ca UNIVERSITY
More informationNational Cancer Peer Review Programme
National Cancer Peer Review Programme Julia Hill Acting Deputy National Co-ordinator What is Cancer Peer Review? A quality assurance process for cancer services. An integral part of Improving Outcomes
More informationFrom Analytics to Action
From Analytics to Action Overview So, what are we talking about here? How to make incremental changes to your digital content that will result in positive user actions Overview Rooted in the hard sciences
More informationInspire Medical Systems. Physician Billing Guide
Inspire Medical Systems Physician Billing Guide 2019 Inspire Medical Systems Physician Billing Guide This Physician Billing Guide was developed to help providers correctly bill for Inspire Upper Airway
More informationHealth Systems Adoption of Personalized Medicine: Promise and Obstacles. Scott Ramsey Fred Hutchinson Cancer Research Center Seattle, WA
Health Systems Adoption of Personalized Medicine: Promise and Obstacles Scott Ramsey Fred Hutchinson Cancer Research Center Seattle, WA Cancer Pharmaceutical Pricing Bach P. NEJM 2009;360:626 Opportunities
More informationCurators of the University of Missouri - Combined January 01, 2013 through December 31, 2013 Cost Management Report
Cost Management Report Program Design Specifics Standard Claims Management SAVINGS CATEGORIES SAVINGS RESULTS % OF NET SUBMITTED DOLLARS % OF PAID DOLLARS Deductible Applied $1,296,627 5.68% 9.78% Patient
More informationThe lymphoma-associated NPM-ALK oncogene elicits a p16ink4a/prb-dependent tumor-suppressive pathway. Blood Jun 16;117(24):
DNA Sequencing Publications Standard Sequencing 1 Carro MS et al. DEK Expression is controlled by E2F and deregulated in diverse tumor types. Cell Cycle. 2006 Jun;5(11) 2 Lassandro L et al. The DNA sequence
More informationTGL clinical User Guide
TGL clinical User Guide The Institute of Cancer Research Brookes Lawley Building 15 Cotswold Road Sutton, Surrey SM2 5NG Page 1 of 7 TGL clinical This document describes the services provided by TGL clinical
More informationUpdate on Pandemic H1N1 2009: Oman
Update on Pandemic H1N1 29: Oman Dr Idris Al-Abaidani, MoH Websites: who.int, ecdc.europa.eu, cdc.gov, moh.gov.om 212 countries reported cases and 15921 deaths Seasonal Flu & H1N1 29 Flu *The reported
More informationImplementation of an Interprofessional Team to Prevent Inpatient Hypoglycemic Events. September 13, 2016
Implementation of an Interprofessional Team to Prevent Inpatient Hypoglycemic Events September 13, 2016 St Joseph s Health Fast Facts Founded 1869 by Sisters of St. Francis Patient Volumes (2014) Inpatient
More informationCancer Screening Program
Cancer Screening Program Mountain Park Health Center/Mayo Clinic Collaboration Region IX Management Training Conference November 11 th, 2008 Mountain Park Health Center! Founded in 1980! Services: Pediatrics,
More informationAn innovative multi-dimensional NGS approach to understanding the tumor microenvironment and evolution
An innovative multi-dimensional NGS approach to understanding the tumor microenvironment and evolution James H. Godsey, Ph.D. Vice President, Research & Development Clinical Sequencing Division (CSD) Life
More informationRoutine HIV Testing in Healthcare Settings: Reimbursement & Sustainability Updated October, 2017
Routine HIV Testing in Healthcare Settings: Reimbursement & Sustainability Updated October, 2017 Overview Importance of routine testing Current recommendations for testing Reimbursement for HIV counseling
More informationIndustry s Contribution to Education for Prenatal Genetic Testing Arnold W. Cohen, MD Chairman, Clinical Advisory Board CAPS
Industry s Contribution to Education for Prenatal Genetic Testing Arnold W. Cohen, MD Chairman, Clinical Advisory Board CAPS May 21, 2018 Agenda Introduction to CAPS Key Points Industry Role in Education
More informationPersonalized Medicine Disruptive Technology? David Logan Senior Vice President, Commercial Genomic Health Inc
1 Personalized Medicine Disruptive Technology? David Logan Senior Vice President, Commercial Genomic Health Inc Safe Harbor Statement This presentation contains forward-looking statements within the meaning
More informationStage Data Capture in Ontario
Stage Data Capture in Ontario February 23, 2010 Agenda Refresher: Ontario s Stage Capture Project Collaborative Staging and Population Stage Reporting in Ontario Use of Stage Data in System Performance
More informationInfluenza Surveillance Animal and Public Health Partnership. Jennifer Koeman Director, Producer and Public Health National Pork Board
Influenza Surveillance Animal and Public Health Partnership Jennifer Koeman Director, Producer and Public Health National Pork Board Outline Background on influenza surveillance in swine Case example animal
More informationSouth Plains Emergency Medical Services, Inc. P.O. Box Lubbock, Texas 79453
South Plains Emergency Medical Services, Inc. P.O. Box 53597 Lubbock, Texas 79453 June 28, 2017 TO: SPEMS EMS Services SUBJECT: SPEMS PARAMEDIC PROTOCOL VARIANCE With the ongoing medication shortages,
More informationQuality Indicators - Anatomic Pathology- HSC/STC Jul-Sep 2 nd Qtr. Apr-Jun 1 st Qtr
Eastern Health Volume 86 Page 001 CIHRT Exhibit P-3595 Page 1 INDICATOR Financial Overtime Hours / FTE Workload Increase - FTE equivalent Workload Quality Indicators - Anatomic Pathology- HSC/STC TOTAL
More informationPalliative Care and Hospice in an Accountable Care Model. Key Strategies to a Successful Integrated Delivery System
Palliative Care and Hospice in an Accountable Care Model Key Strategies to a Successful Integrated Delivery System Monique Reese DNP, ARNP, FNP-C, ACHPN Lori Bishop RN, CHPN Objectives Describe the formation
More informationSurgical Site Infection (SSI) Surveillance Update (with special reference to Colorectal Surgeries)
Surgical Site Infection (SSI) Surveillance Update (with special reference to Colorectal Surgeries) Where we started and where we re going Anjum Khan MBBS MSc CIC Infection Control Professional Department
More informationIcd 10 for g0436 ICD G0436 ICD G0436 ICD ICD ICD G0436 ICD G0436 ICD
Icd 10 for g0436 reported with diagnosis codes ICD-10- CM: F17.200, F17.201, F17.210, F17.211, F17.220, F17.221, F17.290,. F17.291, T65.211A,. HCPCS CODES. G0436. Smoking and tobacco cessation counseling
More informationKENT BISHOP M.D. ProMedica Chief Experience Officer President Women s Service Line
KENT BISHOP M.D. ProMedica Chief Experience Officer President Women s Service Line 1 WHEN A VISION TAKES SHAPE. 2 3 4 Modern Facilities Clinical Service Lines Quality/ Safety Mental Health Clinical Research
More informationAdministrative Consultant for Endocrine Offices
Business Manager & Consultant Administrative Consultant for Endocrine Offices 703 Mt Rock Rd Carlisle, PA 17015 Tel: 717-798-4820 (Cell) CPT is a registered trademark of AMA. Endocrinology Is it: Patient
More informationImprovement Initiative for Patient Falls Susan Moffatt-Bruce, B.Sc. (Hon), M.D., Ph.D., FRCS(C), FACS, MBOE, Chief Quality and Patient Safety Officer
Improvement Initiative for Patient Falls Susan Moffatt-Bruce, B.Sc. (Hon), M.D., Ph.D., FRCS(C), FACS, MBOE, Chief Quality and Patient Safety Officer Amy M. Knupp MSN, RN, CNS, CPPS, Director of Nursing
More informationUnderstanding public and private genetic testing for cancer risk. Frequently asked questions
Understanding public and private genetic testing for cancer risk Frequently asked questions What is genetic testing for cancer risk? Certain gene faults (also called mutations or variants) increase the
More informationE & M Coding: Are You Leaving Money on the Exam Table?
ACS, PAHCOM & HNA Sponsored Practice Management Webcast Series March 2, 201 1 E & M Coding: Are You Leaving Money on the Exam Table? Introduction - Evaluation and Management Services (E&M Coding) are a
More informationPoster Session HRT1317 Innovation Awards November 2013 Brisbane
Poster Session HRT17 Innovation Awards November 20 Brisbane Presenter: Keren Harvey, Clinical Director Rehabilitation and Geriatric Medicine, TPCH Visibility enhancing the Geriatric & Rehabilitation Liaison
More informationDate : September Permit/License or Registration Application. Permit/License/ Notification/ Registration Description. Remark
Number 1. s 29 Jul 13 N/A Environmental Permit to construct the Passenger Clearance and associated works of the Hong Kong Zhuhai and Macao Bridge Boundary Crossing Facilities EP-353/2009/G 06 Aug 13 N/A
More informationAVENIO family of NGS oncology assays ctdna and Tumor Tissue Analysis Kits
AVENIO family of NGS oncology assays ctdna and Tumor Tissue Analysis Kits Accelerating clinical research Next-generation sequencing (NGS) has the ability to interrogate many different genes and detect
More informationEnterprise Interest Thermo Fisher Scientific / Employee
Enterprise Interest Thermo Fisher Scientific / Employee A next-generation sequencing assay to estimate tumor mutation load from FFPE research samples Fiona Hyland. Director of R&D, Bioinformatics Clinical
More informationLynch Syndrome and COLARIS Testing
Lynch Syndrome and COLARIS Testing Webinar Objectives Review of Lynch syndrome as a multi-gene disorder COLARIS Enhancements Technical Overview COLARIS test offerings Test development and validation process
More informationMACRA Roadmap: An Overview of the Quality Payment Program in Suzanne Falk, MPP Senior Associate, Regulatory Affairs
MACRA Roadmap: An Overview of the Quality Payment Program in 2019 Suzanne Falk, MPP Senior Associate, Regulatory Affairs sfalk@acponline.org Today s Game Plan: At a Glance: Major Proposed QPP Changes QPP
More informationCurators of the University of Missouri - Combined January 1, 2016 through December 31, 2016
Cost Management Report Delta Dental Network Coverage Network Utilization Discount Delta Dental PPO Network 28.3% 29.4% Delta Dental Premier Network 67.0% 12.0% Total 95.3% Savings Categories $ % of Net
More information