Presentation 5: Payer Perspectives on Genetic Counseling
Karen Lewis, MS, MM, CGC
Karen uses this session to analyze payer perspectives in genetic counseling. She describes the process involved with genetic counseling and the role of the counselor. She notes that the path to becoming a genetic counselor can often be more rigorous than in other specialties. Ms Lewis also discusses the surge of interest that genetic counseling has seen in recent years.
“Most of you are very well aware of potential personalized medicine, looking at various tumor markers and knowing well, an individual that has this mutation is not going to respond well to treatment A and therefore, we need to try treatment B instead. Individuals want to know this information,” she says. “It’s everywhere. I don’t know a TV program out there that—in some way, shape, or form—hasn’t used genetics or testing or something in their plot line.”
However, she warns that some clinics may only use genetic counseling as a path to profit. Another issue for some may be access, as there are only about 3000 board-certified genetic counselors in the United States, and they are concentrated in large metropolitan areas. She also suggests that genetic testing must be given appropriately to patients.
“I think the benefits of utilization of genetic counseling are multiple, but one of the biggest benefits is avoiding inappropriate testing. Not avoiding testing in general, just avoiding the wrong test. So, what we want to do is make sure that the right tests are being given to the right patients,” Ms Lewis says.
Overall, comprehensive policies and genetic testing have potential to improve care, improve cost-effectiveness, and improve outcomes.