#USA #Tampa #Genetic Testing #Avalon Healthcare #Lab Testing

Avalon 2025 Lab Trend Report Overview

The latest Avalon 2025 Lab Trend Report unveils significant developments in the laboratory testing domain, with a notable surge in genetic and biomarker testing. As traditional diagnostics reach a stage of stabilization, the report provides critical insights into the evolving healthcare landscape.

Key Findings

Avalon Healthcare Solutions, the leader in diagnostic intelligence, released the fifth edition of their Lab Trend Report, leveraging data from 18 million health plan members—a substantial part of their 44 million managed lives. The report emphasizes that while lab testing remains the most exploited medical benefit, it continues to be poorly managed in many healthcare settings.

Bill Kerr, MD, CEO of Avalon Healthcare Solutions, stresses the need for modernization in diagnostics selection, delivery, and payment to enhance healthcare outcomes. "Our report offers health plans data-driven insights essential for enhancing health care quality while reducing costs," he remarked.

Pricing Discrepancies

One striking observation from the report is the discrepancies in testing prices based on location. For instance, a basic metabolic panel priced at $8.51 in an independent lab was charged at $12.04 in a physician's office, and an astounding $48.45 in hospital outpatient labs. This highlights a troubling trend where hospital settings impose nearly six times higher costs than independent labs, contributing to inflated healthcare expenses.

Trends in Routine Testing

Routine testing continues to dominate hair markets, responsible for approximately 90% of all testing by volume. Interestingly, the cost incurred by health plans for such tests averaged $192 per member per year (PMPY) last year, marking a 2% uplift from the previous year. The report also noted a 4% rise in routine testing costs, while the COVID testing spend saw a significant drop of 27%. Overall, the decline in testing volumes can largely be attributed to reduced COVID testing activities as the pandemic eases.

Exponential Growth in Genetic Testing

In contrast to the stabilization in routine diagnostics, there is a remarkable increase in genetic testing. The average health plan's expenditure on genetic testing rose to $14.80 PMPY, a 10% increase from the previous year, with the utilization of these tests also growing by the same margin. Despite constituting only 10% of total testing volume, genetic testing accounts for a staggering 30% of payer spending in diagnostics. From 2020 to 2024, spending on genetic testing surged by 66%, demonstrating a robust shift towards personalized medicine and improved diagnosis capabilities.

Emerging Trends in Biomarker Testing

The report identifies biomarker testing as an emerging trend with significant implications in the diagnostics landscape. Biomarkers are increasingly used for various roles, including risk assessment, diagnosis, treatment planning, and monitoring disease progression. Notable advancements highlighted in the report include:

• - Multi-cancer early detection (MCED) tests that identify cancer signals in the blood.
• - Polygenetic risk score (PRS) tests estimating an individual's risk for common conditions.
• - Tests aimed at assessing Alzheimer's disease by measuring amyloid levels in the blood.

Dr. Kristie Ressler, Chief Medical Officer at Avalon, emphasizes the necessity for advanced strategies for healthcare providers to ensure that diagnostic tests are effectively utilized to drive better care outcomes.

Conclusion

As Avalon moves forward in shaping the future of healthcare diagnostics, the insights from the 2025 Lab Trend Report serve as a compass for health plans confronting the complexities of rising diagnostic demand and variability in healthcare costs. This pivotal report not only acts as a revealing lens into current challenges but also indicates pathways towards improved diagnostic management that can ultimately propel the healthcare sector into a more efficient and value-driven future.

For additional details, the complete Avalon 2025 Lab Trend Report is available for download on their website.