BioConnetiX provides a fast, stable, and cost-effective method for payors to manage system-wide laboratory care, even outside of genetic medicine. We work with insurance companies to develop programs that afford immediate utilization controls followed by measured, right-paced implementation of new disease-process workflows to manage specific risks, issues, and costs inherent to that system. Once insurance companies sign off on the plan, BioConnetiX provides education and implementation services to laboratories for network preference.

BioConnetiX offers three solutions for insurance plans, with specific programs for controlling utilization & pricing, managing costly disease processes, and eliminating redundancy & risk. Outcomes are reported at all levels of integration. As systems progress into more advanced stages, greater insights and additional metrics yield increasingly powerful results, providing systems with clear data from which to make coverage and future policy decisions. Further, as systems amass deeper genetic databases, a, patient risks can be identified further in advance and at a fraction of the cost of current models.

Program 1: Eliminate Overutilization & Control Pricing for Toxicology and Genetic Tests Billed to your Network

Payors open to extending preference payment models or policy systems that leverage centralization, aligned operations, technology, and resources based on specialization receive assurance of proper utilization. Insurance plans garner immediate and long-term value by extending network preference for laboratories participating in the regimented INTEGRATE process - a structured multi-year operational program that provides immediate price controls and utilization management in Stage 1, followed by longer term validations focused on alignments, standardization and specialization. The INTEGRATE program provides a structure and common language for collaboration - lowering costs and improving outcomes at an increasing pace as laboratory participation grows and individual laboratories achieve more sophisticated levels of implementation. Through this process, centralization affords growing economies of scale, standardization allows for both emergency preparedness and the provision of large-scale testing needs at a fraction of current costs, and specialization provides the focused effort required to affordably operationalize molecular laboratory work-up tests for entire disease processes.

Program 2: Lower Overall Cost of Care through Structured Disease-State Management with Personalized Medicine

Insurance companies open to considering framework pilots for genetic-care delivery within single high-cost disease processes can garner immediate cost savings and continuously improving outcomes. Low-resource and capitated healthcare settings have the advantage of the earliest adoption of precision medicine in many cases - targeting specific population health needs and nimbly implementing protocols for single high-value disease processes without the encumbrances of gridlocked infrastructure. Results data from these populations can then be used to refine Early Warning Score (EWS) indicators, drug-dose guidance, and other protocols throughout the network.

Program 3: Leverage Technology to Eliminate Redundant Testing & Reduce Patient Risk

Although most healthcare systems and providers of care have regulations that force doctors and providers to manage the schedule of follow-up care, the reality is that technology can manage appointments, required tests, reminders, and transitions of care with much greater accuracy and at a dramatically lower cost than humans. Payors can leverage telemedicine to connect to the foremost experts of each disease-process for care plan development and assignment, and make laboratory selections within the connected network to ensure utilization controls and adherence to defined pathways as they are developed and launched. Compliance scoring is reported by both administering provider and patient, based on patient adherence to the prescribed plan of care. This quantitative approach puts patients on the accountability seat for a portion of their care, and gives payors data that is far more beneficial than qualitative pedometer and healthy habit scoring models currently in use.

BioConnetiX connects the complex ecosystem of care providers required to transform fragmented, costly laboratory testing into evidence-based, personalized care from a foundation in genetic science. It is the first healthcare platform of its kind to harness physician, scientist and operator specialization to comprehensively manage the entire supply chain in the continuum of laboratory care. Extensive partner collaboration with research institutions, molecular pathologists, and laboratory operators is paramount our ability to capture the full value of genetic laboratory medicine.

Clinical standards and value are addressed by integrating foundations from medical practice into the laboratory industry through regimented operational deployment. Pricing controls, utilization outlier detection, and telehealth-driven review and workup management occur upon deployment and progress through a series of increasingly ambitious operational, clinical and financial thresholds. Clinical pathways are supported with sophisticated decision-support technology. Specialization, standardization, centralization, and alignment within partner laboratories allow for dramatically reduced costs and timely, consistent performance. Analytics measures report user adherence to protocols, clinical and financial outcomes, benchmark performance data, and a growing set of other measures.

In order to transform research discoveries into practical applied science, there is an unequivocal need to organize laboratory health histories and genetic databases by patient instead of by provider. This will allow for automated mapping of new discoveries to existing genomic data, eliminating costly redundancy and dramatically reducing patient risk. BioConnetiX cognitive software provides agnostic translation of laboratory test results from otherwise disparate laboratory information management systems, establishing an ambitious new standard to streamline result translation into common language (LOINC).

Comprehensive personal laboratory medical records with trended chronologies allow for timeline-based analytics, continuity of care through a patients lifetime of care transitions, and system-agnostic accountable care management. Centralization of critical results, indicators and pharmacologic instruction are the only solution for the effective management of clinical emergencies. Centralization also allows for access to specialized molecular laboratory workup, counseling and other care management resources.