Complex Case Management and New Technology Series: Pilot on Genomics in Context​

Join this Precision Medicine-Based, Complex Case Management Research Study​

Study Lead

The Center for Workforce Health and Performance (CWHP), led by Dr. Kimberly Jinnett, will study the outcomes of employee populations after medical genomics are facilitated, case managed, and applied in high-risk, highly complex plan members. This study will focus on clinical and cost reduction outcomes of medical genomics in employee populations. The entire medical genomic process will be facilitated by Rx-Precision.
Kimberly Jinnett, PhD, MSPH

Kimberly Jinnett, PhD, MSPH

President

Center for Workforce Health and Performance Affiliate Faculty

Scientific Advisory Board

Scott Weissman, MS

Scott Weissman, MS

Proactive Service Lead

Genome Medical

Steve Bleyl

Steve Bleyl

Chief Medical Officer

Genome Medical

Momo Vuyisich, PhD

Momo Vuyisich, PhD

Chief Science Officer

Viome, Inc

Guruduth Banavar

Guruduth Banavar

Chief Technology Officer

Viome, Inc

Tyler Koep, PhD

Tyler Koep, PhD

Medical Affairs

OneOme

Jason Ross

Jason Ross

Chief Technology Officer

OneOme

Members That Benefit From This Study​

This intervention focuses on employees with chronic illnesses, complex medical needs, and highest risk such as those with diagnosis of autoimmune disease, cancer, depression, diabetes and chronic pain—most of which are experiencing multiple disease states at once or co-morbid. The population targeted will make up the 10% highest risk of your health plan that is spending 80% +/- of your plan assets.
“This research will provide further insight on how to bring the benefits of precision medicine to a larger population of plan participants who would realize a benefit.”​

Benefits to the Health Plan and Employer​

Each employee enrolled in this ground-breaking research will receive clinical support, along with their physician, to have their prescription treatment plan personalized to their DNA using clinical genetic testing. Historically, over 80% of the employees that experience this process will have a change made to optimize their medications—causing them to experience better clinical outcomes and lower their costs. The goal is to reduce the unnecessary spending on prescriptions that will not work for the employees and achieve the Triple Aim for the employer.

The employer can expect patients that feel better, are happier and spend less of the health plan’s assets over time. This study is designed to quantify this and measure the total impact, providing employers with independently-validated data around a new option for helping high-risk plan members get better clinical outcomes.  The study will also address care coordination, cost and quality of life concerns from the patient, provider and employer perspectives, providing valuable insights around implementation of precision medicine interventions for outcome improvement. The study will also address care coordination, cost and quality of life concerns from the patient, provider and employer perspectives, providing valuable insights around implementation of precision medicine interventions for outcome improvement.

The Intervention Process

 

RX Intelligence

Employees meeting the research criteria are identified via claims data or approved through a referral process established with the health plan or health plan’s case management provider.

Telegenomics & Physician Support

The employee and their physician are provided with tools, education, and any peer-to-peer clinical decision support to implement treatment changes securely and immediately

Member Enrollment Process

Employees receive education about the intervention via our enrollment specialists and are given the option to participate in the program.

Research Surveying

At the end of the process, members, physicians, and the employer will be given an option to participate in a survey.​

DNA Test Matching & Support

Employees opting-in will be matched to the optimal genomic panel and be supported through a clinical genomic case management process.​

Data Reporting of Outcomes

Plan receives data on clinical outcomes post intervention and cost reduction based on actual claims trends.

What Plan Sponsors and Participants Receive

Clinical Outcomes

Each study participant will provide baseline pre-intervention clinical data relevant to their current clinical condition. This data will be studied against post-interventional data at intervals of 3, 6 and 12 months to show the effectiveness of the intervention on improving clinical outcomes.

Example Clinical Data Includes:

Blood Pressure

Glucose and A1c

BMI

Waist/Hip Measurement

Symptoms Related to Diagnosis

Process Outcomes

Once the intervention is complete, each study participant, their physician and their health plan will be offered the opportunity to answer brief questionnaires gathering their experience with the intervention, care coordination process and value of this new technology.

Details Include:

E

Patient Experience: Absenteeism, Presenteeism, Productivity, Care Satisfaction, Psychosocial Stress

E

Physician Experience: Care Coordination, Integrating New Technology, Quality of Care

E

Health Plan Experience: Cost Concerns, Implementation via Plan & Providers, Care Coordination

Claims and Cost Outcomes

Medical and pharmaceutical claims data including but not limited to utilization, prevalence of services, dosages, claims patterns and costs will be studied pre and post intervention to evaluate the effectiveness of the intervention in reducing claims costs.

Claims data will be studied in both the participant group as well as the control group that qualified for the intervention but opted-out. Controls will be in place to ensure data reported is accurate and accounts for outliers and regression.

agsdi-analysis

Lab Testing

Testing done from the comfort of patient’s home and sequenced by a premier genomic laboratory.

agsdi-doctor

Genetic Experts

Genetic counselors perform pre and post test consults and support the member throughout the process.

agsdi-people

Peer to Peer Support

Physician and patient support is provided by genetic counselors and the lab’s clinical support team.

agsdi-list

Genetic Report

Report providing medication responses and potential negative drug interactions for each patient.

agsdi-zoom

Clinical Action Plan

Treatment insights derived from the patient’s results by a genetic counselor.

Companies Involved in the Study

The Cost to Participate

Each employer will provide a pre-determined minimum number of their employees access to the study by signing a simple agreement and by paying a per-enrolled, one-time bundled study fee per employee participating. This fee will be billed to the employer’s claims fund as a medical claim and is used to fund the research staff and process, clinical genomic case management process, telemedicine genetic specialist visits for the employee and their physician, DNA analysis and reporting and publishing of the research once the study has concluded. For reference, this fee is roughly 90% of Medicare reimbursement for only the doctor’s prescription of the genomic panel, the analysis process and the reporting.

Complex Case Management and New Technology Series: Pilot on Genomics in Context​

Join this Precision Medicine-Based, Complex Case Management Research Study​

Study Lead

The Center for Workforce Health and Performance (CWHP), led by Dr. Kimberly Jinnett, will study the outcomes of employee populations after medical genomics are facilitated, case managed, and applied in high-risk, highly complex plan members. This study will focus on clinical and cost reduction outcomes of medical genomics in employee populations. The entire medical genomic process will be facilitated by Rx-Precision.
Kimberly Jinnett, PhD, MSPH

Kimberly Jinnett, PhD, MSPH

President

Center for Workforce Health and Performance Affiliate Faculty

Scientific Advisory Board

Scott Weissman, MS

Scott Weissman, MS

Proactive Service Lead

Genome Medical
Steve Bleyl

Steve Bleyl

Chief Medical Officer

Genome Medical
Guruduth Banavar

Guruduth Banavar

Chief Technology Officer

Viome, Inc
Momo Vuyisich, PhD

Momo Vuyisich, PhD

Chief Science Officer

Viome, Inc
Jason Ross

Jason Ross

Chief Technology Officer

OneOme
Tyler Koep, PhD

Tyler Koep, PhD

Medical Affairs

OneOme

Members That Benefit From This Study​

This intervention focuses on employees with chronic illnesses, complex medical needs, and highest risk such as those with diagnosis of autoimmune disease, cancer, depression, diabetes and chronic pain—most of which are experiencing multiple disease states at once or co-morbid. The population targeted will make up the 10% highest risk of your health plan that is spending 80% +/- of your plan assets.
“This research will provide further insight on how to bring the benefits of precision medicine to a larger population of plan participants who would realize a benefit.”​

Benefits to the Health Plan and Employer​

Each employee enrolled in this ground-breaking research will receive clinical support, along with their physician, to have their prescription treatment plan personalized to their DNA using clinical genetic testing. Historically, over 80% of the employees that experience this process will have a change made to optimize their medications—causing them to experience better clinical outcomes and lower their costs. The goal is to reduce the unnecessary spending on prescriptions that will not work for the employees and achieve the Triple Aim for the employer.

The employer can expect patients that feel better, are happier and spend less of the health plan’s assets over time. This study is designed to quantify this and measure the total impact, providing employers with independently-validated data around a new option for helping high-risk plan members get better clinical outcomes.  The study will also address care coordination, cost and quality of life concerns from the patient, provider and employer perspectives, providing valuable insights around implementation of precision medicine interventions for outcome improvement. The study will also address care coordination, cost and quality of life concerns from the patient, provider and employer perspectives, providing valuable insights around implementation of precision medicine interventions for outcome improvement.

The Intervention Process

 

RX Intelligence

Employees meeting the research criteria are identified via claims data or approved through a referral process established with the health plan or health plan’s case management provider.

Member Enrollment Process

Employees receive education about the intervention via our enrollment specialists and are given the option to participate in the program.

DNA Test Matching & Support

Employees opting-in will be matched to the optimal genomic panel and be supported through a clinical genomic case management process.​

Telegenomics & Physician Support

The employee and their physician are provided with tools, education, and any peer-to-peer clinical decision support to implement treatment changes securely and immediately

Research Surveying

At the end of the process, members, physicians, and the employer will be given an option to participate in a survey.​

Data Reporting of Outcomes

Plan receives data on clinical outcomes post intervention and cost reduction based on actual claims trends.

What Plan Sponsors and Participants Receive

Clinical Outcomes

Each study participant will provide baseline pre-intervention clinical data relevant to their current clinical condition. This data will be studied against post-interventional data at intervals of 3, 6 and 12 months to show the effectiveness of the intervention on improving clinical outcomes.

Example Clinical Data Includes:

Blood Pressure

Glucose and A1c

BMI

Waist/Hip Measurement

Symptoms Related to Diagnosis

Process Outcomes

Once the intervention is complete, each study participant, their physician and their health plan will be offered the opportunity to answer brief questionnaires gathering their experience with the intervention, care coordination process and value of this new technology.

Details Include:

E

Patient Experience: Absenteeism, Presenteeism, Productivity, Care Satisfaction, Psychosocial Stress

E

Physician Experience: Care Coordination, Integrating New Technology, Quality of Care

E

Health Plan Experience: Cost Concerns, Implementation via Plan & Providers, Care Coordination

Claims and Cost Outcomes

Medical and pharmaceutical claims data including but not limited to utilization, prevalence of services, dosages, claims patterns and costs will be studied pre and post intervention to evaluate the effectiveness of the intervention in reducing claims costs.

Claims data will be studied in both the participant group as well as the control group that qualified for the intervention but opted-out. Controls will be in place to ensure data reported is accurate and accounts for outliers and regression.

agsdi-analysis

Lab Testing

Testing done from the comfort of patient’s home and sequenced by a premier genomic laboratory.

agsdi-doctor

Genetic Experts

Genetic counselors perform pre and post test consults and support the member throughout the process.

agsdi-people

Peer to Peer Support

Physician and patient support is provided by genetic counselors and the lab’s clinical support team.

agsdi-list

Genetic Report

Report providing medication responses and potential negative drug interactions for each patient.

agsdi-zoom

Clinical Action Plan

Treatment insights derived from the patient’s results by a genetic counselor.

Companies Involved in the Study

The Cost to Participate

Each employer will provide a pre-determined minimum number of their employees access to the study by signing a simple agreement and by paying a per-enrolled, one-time bundled study fee of $2,000 per employee participating. This fee will be billed to the employer’s claims fund as a medical claim and is used to fund the research staff and process, clinical genomic case management process, telemedicine genetic specialist visits for the employee and their physician, DNA analysis and reporting and publishing of the research once the study has concluded. For reference, this fee is roughly 90% of Medicare reimbursement for only the doctor’s prescription of the genomic panel, the analysis process and the reporting.

Request More Information

We are excited to partner with you on improving care for your employees and finding new solutions to impact our biggest health care challenges. Please fill out the form below to get started.

Request More Information

We are excited to partner with you on improving care for your employees and finding new solutions to impact our biggest health care challenges. Please fill out the form below to get started.