What We Do
Getting to the Heart of Value-Driven Care
Even though $82B is spent each year on lab testing in the US, it doesn’t always get the attention it perhaps deserves. When you look closer at the 13+ billion lab tests performed annually, you uncover that:
- 30% of lab tests are unnecessary,
- Another 30% of patients don’t get the tests they need
- 1 in 3 genetic tests are ordered in error and even the right test’s results are frequently misunderstood
- Costs vary dramatically by type of lab and where the lab is referenced.
The most common breakdowns in delivering value-driven care are failure to order an appropriate diagnostic test, incorrect interpretation of diagnostic tests, and failure to create a proper follow-up plan.
Health plans pay for broad lab testing for their members but have never unlocked and used lab data to its full potential to broadly inform care and improve outcomes. It was never possible—until now with Avalon’s comprehensive Lab Insight System.
Our commitment is to leverage laboratory science, innovation, and technology to bring novel lab insights and provide value-driven solutions that matter to payers, providers and patients.
Lab Insights System
Lab benefit management has traditionally been focused on removing waste and abuse from lab testing, helping to navigate the increasing complexities of genetic testing, and helping health plans reduce their independent network unit cost. While this has a proven value, it really ends with adjudication of the lab claim and delivery of the result to the physician.
Avalon still delivers impactful lab benefit management services, but now we go far beyond that as the world’s first Lab Insights company. Lab Insights expands value by driving quality clinical outcomes and proven cost savings. You shouldn’t have to choose one over the other.
Avalon’s comprehensive Lab Insight System impacts a far greater portion of the health plan spend, including specialty pharmacy and medical costs. We unlock the power of lab data and take a whole patient view to optimize treatment, improve outcomes, and drive down overall cost.
Bringing Lab Insights to Life
Avalon lab data doesn’t let potential costly, long-term diseases hide.
There are 37 million chronic kidney disease (CKD) cases in the U.S. An overwhelming 90% of Americans don’t even know they have it. And, sadly, by the time it’s diagnosed, nine out of ten are Stage 3 or even later.
If we could only identify the disease sooner. We can. Avalon’s Lab Insight System helps us detect diseases like CKD earlier, which can help delay End-Stage Renal Disease (ESRD). Not by months. But by years.
We’d be more informed and better prepared to improve outcomes for a healthier population. Early detection helps us avoid a tremendous amount of time and money downstream, while improving quality of life for your members. Plus, it’s yet another step toward value-driven care.
Let’s say, case in point, a physician orders a lab panel, and the panel shows “normal” creatinine. Results sent to EMR. No follow up.
Now here’s the Avalon Lab Insights difference at work.
If we had digitally transformed those results with our Lab Insights Engine, our data would have revealed an upward trend as the previous creatinine value from a year ago was half the amount. Avalon would have flagged this doubling of creatinine as an “emerging risk.”
So, while the EMR file might sit collecting dust, marked as “normal,” our data and experts have identified a critical lab-driven insight. Normal is not so normal.
At this point, we’d inform the Health Plan Care Management team. The doctor would likely revisit the case and indeed confirm early-stage CKD and active care would begin.
All this, if not for Avalon’s invaluable lab insights, would have gone unnoticed and untreated, which is unacceptable.
This is just one example. Our lab-driven insight holds the key to a successful value-driven future. One that will save countless hours, stresses, dollars, and above all, lives.
Avalon uncovers critical insights to ensure breast cancer treatment and genetic testing join forces to optimize care.
The possibilities of genetic testing are encouraging. The realities are almost crippling.
There are nearly 70,000 genetic tests on the market, with an average of 10 new ones entering the market each day. Keeping up with what can be measured, when it is relevant, how to interpret the results, and how much the test should cost is a struggle for health plans, providers, and certainly individuals who are looking to manage their own health.
Avalon can eliminate the guesswork and make healthcare as affordable and actionable as possible while embracing innovation in science and health management.
Cancer is one of the most deadly—and most expensive—diseases on our planet.
But even cancer treatment plans have room for improvement. If we spot it sooner. This not only gives us a precious jump start on the appropriate treatment plan, it fosters a beneficial relationship between cancer treatment and genetic testing. One that works in parallel paths, complimenting one another, for the best possible outcome. Genetic testing is a powerful tool and can work to our advantage if we also leverage the important information inside our lab data.
For example, imagine a doctor discovers a lump during a routine breast exam. A biopsy is sent to the hospital pathology lab for analysis of the tissue. It indeed reveals cancer. In addition, the cancer biopsy tissue is sent to a genetic lab provider for genomic testing of the cancer tissue.
Promising news: The patient’s genomic test results show that in this case, “Chemo NOT indicated” as the cancer tissue genomic mutations are unlikely to spread.
Here’s where Avalon takes us all one step closer to value-driven care success.
With our Lab Insights Engine, we can capture and digitize the genetic test results in real time. This step, critical to uncover all the magic inside our data, helps the oncologist and health plan deliver the optimal treatment for the patient—data-driven and evidence-based and in this case, no systemic chemotherapy.
This is a prime example of the critical difference Avalon delivers: Genomic test results and lab-informed cancer treatment are in sync from start to finish. The result? Optimal outcomes for cancer patients. Optimal outcomes, too, for providers, health plans and patients. This creates a convergence of precision and personalized medicine like never before.