TAMPA, Fla., March 12, 2024 – Health plans overwhelmed by the explosive growth in genetic testing now have a way to manage the tests that ensure quality, decrease costs, and reduce administrative burden.

AvalonSelect Genetic Network from Avalon Healthcare Solutions, the world’s first lab insights company, is a carefully curated group of genetic testing labs paired with expert consultative services. A supplement to health plans’ current routine testing networks, it was created specifically to address genetic testing. Health plans outsource the management of genetic testing, pricing, compliance enforcement, test quality assessment, new test evaluation, and contracting to Avalon.

“Genetic testing is an important precision medicine tool, but like any technology it needs to be managed correctly in order to provide the maximum benefit,” said Avalon President Pamela Stahl. “AvalonSelect Genetic Network provides plans with a simplified approach to genetic test management while improving the quality of genetic tests provided to members.”

Plans and providers are simply overwhelmed by the rapid rise in the number and variety of genetic tests. There are more than 175,000 tests on the market with more than 10 new ones added daily. The volume is just too great for plans to be able to evaluate the clinical utility and validity of each test. Similarly, providers cannot familiarize themselves with every possible test or know how to integrate their results into care decisions. Ensuring access to quality testing while controlling costs has become increasingly complex and resource intensive. Also, more states are passing biomarker legislation mandating insurers cover types of genetic testing, which will only add to the volume and spend.

AvalonSelect Genetic Network offers plans an average savings of 10% or more on overall genetic test spend leveraging a preferred nationwide program. It is based on Avalon’s extensive lab contracting experience and evidence-based new test evaluations to drive access to quality tests while simplifying the complexity and costs of genetic testing. It includes:

• Reduced or eliminated prior authorization (PA) for gold-carded lab providers
• Simplified administration and reduced health plan burden
• Quality enforcement through strict performance criteria
• Credentialing support and emerging technology review service
• An improved provider experience and consistent reimbursement expectations
• Reduced potential for fraud, waste, and abuse
• Collaboration with the plan’s internal network team

The AvalonSelect Genetic Network is comprised of quality genetic labs that perform non-proprietary, high-volume testing covering 95% of the total genetic test menu. Labs want to join AvalonSelect because it offers reduced PA, fast-tracked reimbursement, increased volume and assured reimbursement price, timing, and transparency.

“Genetic testing is too complex and fast-growing to be managed by the system now in place for routine testing,” said Jason Bush, Executive Vice President of Product at Avalon. “It requires a solution designed to meet the specific challenges of genetic testing while ensuring a cost-effective, member-friendly lab network strategy that promotes appropriate utilization and directs members to high-quality labs.”

Genetic testing will become an even more important part of healthcare. AvalonSelect Genetic Network offers plans a better way to harness it for their benefit and that of their members and providers.

For more information about AvalonSelect Genetic Network, click here.

About Avalon Healthcare Solutions

Avalon Healthcare Solutions is the world’s first and only Lab Insights company, bringing together our proven Lab Benefit Management solutions, lab science expertise, digitized lab values, and proprietary analytics to help healthcare insurers proactively inform appropriate care, reduce costs, and improve clinical outcomes. Working with health plans nationwide, the company covers over 39+ million lives and delivers 9-20% outpatient lab benefit savings. Avalon is pioneering a new era of value-driven care with its Lab Insights Program that captures, digitizes, and analyzes lab results in real-time to provide actionable insights for earlier disease detection, ensuring appropriate treatment protocols, and driving down overall costs. For more information about Avalon, visit www.avalonhcs.com.

Media Contacts:
Michele Norton MS, RN
SVP Product Marketing, Avalon Healthcare Solutions
[email protected]

Janet Mordecai
Amendola Communications for Avalon Healthcare Solutions
[email protected]