caa a22 4500 605544115 CHVBK 20210128100930.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s10897-014-9745-0 doi (NATIONALLICENCE)springer-10.1007/s10897-014-9745-0 Exploring Barriers to Payer Utilization of Genetic Counselors [Elektronische Daten] [Nan Doyle, Allison Cirino, Amber Trivedi, Maureen Flynn] Access to genetic counselors' services is neither universal nor automatic, due in part to the gatekeeper role of healthcare payers - the companies and agencies that purchase healthcare services on patients' behalf and control the bulk of healthcare spending. This pilot study surveyed and analyzed the relative importance of barriers to expanded payer coverage of genetic counselors' services. Surveys were mailed to 263 medical directors and quality assurance directors at health insurance carriers throughout the United States. Respondents provided demographic information and indicated the importance of nine possible barriers, plus an optional write-in "other.” Twenty-two surveys were analyzed. "Evidence that use of genetic counselors improves health outcomes” led the list of factors having a significant/very significant influence on coverage policy. Sixteen respondents (73%) rated this factor "4” or "5” on a Likert scale; it also received the most #1 rankings and the highest score using a weighted-mean analysis. Provider practice guidelines, CMS/Medicare regulations, and genetic counselor licensure-all of which are outside of payers' direct control-also ranked highly. The research demonstrates that although the potential barriers to expanded reimbursement for genetic counselors are numerous and complex, some are more consistently identified as important and therefore more deserving of legislative and advocacy resources to effect change. Future research should endeavor to increase survey response and include providers as well as payers. (222 words) National Society of Genetic Counselors, Inc., 2014 Genetic Counselor nationallicence Insurance nationallicence Payor nationallicence Payer nationallicence Coverage Policy nationallicence Reimbursement nationallicence Outcomes nationallicence Doyle Nan Division of Graduate Medical Sciences, Boston University School of Medicine, 85 East Newton Street, M913, 02118, Boston, MA, USA aut Cirino Allison Cardiovascular Genetics Center, Brigham and Women's Hospital, Boston,, MA, USA aut Trivedi Amber InformedDNA, 360 Central Ave, 33701, St Petersburg, FL, USA aut Flynn Maureen Division of Graduate Medical Sciences, Boston University School of Medicine, 85 East Newton Street, M913, 02118, Boston, MA, USA aut Journal of Genetic Counseling Springer US; http://www.springer-ny.com 24/1(2015-02-01), 122-133 1059-7700 24:1<122 2015 24 10897 https://doi.org/10.1007/s10897-014-9745-0 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10897-014-9745-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Doyle Nan Division of Graduate Medical Sciences, Boston University School of Medicine, 85 East Newton Street, M913, 02118, Boston, MA, USA aut NATIONALLICENCE 700 1- Cirino Allison Cardiovascular Genetics Center, Brigham and Women's Hospital, Boston,, MA, USA aut NATIONALLICENCE 700 1- Trivedi Amber InformedDNA, 360 Central Ave, 33701, St Petersburg, FL, USA aut NATIONALLICENCE 700 1- Flynn Maureen Division of Graduate Medical Sciences, Boston University School of Medicine, 85 East Newton Street, M913, 02118, Boston, MA, USA aut NATIONALLICENCE 773 0- Journal of Genetic Counseling Springer US; http://www.springer-ny.com 24/1(2015-02-01), 122-133 1059-7700 24:1<122 2015 24 10897