Abstract
While traditional components of genetic counseling sessions are well recognized, less is known about insurance and financial discussions. This study sought to examine “genesurance counseling” which we defined as: that portion of a genetic counseling session, whether intentional or non-intentional, that is devoted to the topic of costs and insurance/third party coverage (particularly for genetic testing). Our objective was to assess genetic counselors’ practices and perspective related to genesurance counseling. A survey link was sent by e-mail to members of the National Society of Genetic Counselors (approximately 3100 NSGC members). A total of 571 genetic counselors participated in the survey of which 550 identified as clinical genetic counselors. Survey data were used to investigate differences between specialties, impact on patient rapport, changes in practice dynamics, and devotion of clinic time. Overwhelmingly, 99% of participants acknowledged conducting genesurance counseling, 87% believed it to be part of their job description, and 85% viewed it as an important aspect of genetic counseling. On average, respondents estimated they devoted 10% of their session, or 6 min, to genesurance counseling. Of the surveyed participants, 95% reported genesurance counseling as having some form of influence in a patient’s decision regarding genetic testing, and 74% stated that genesurance counseling concerns change the practice and dynamic of their clinic. “Genesurance counseling” is not a topic which has been studied to date. Our study highlights the changes in genetic counselors’ roles and responsibilities regarding insurance and financial counseling.
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References
Bernhardt, B. A., Biesecker, B. B., & Mastromarino, C. L. (2000). Goals, benefits, and outcomes of genetic counseling: client and genetic counselor assessment. American Journal of Medical Genetics, 94(3), 189–197.
Doyle, N., Cirino, A., Trivedi, A., & Flynn, M. (2014). Exploring barriers to payer utilization of genetic counselors. Journal of Genetic Counseling, 24(1), 122–133.
Hamel, L., Norton, N., Pollitz, K., Levitt, L., Claxton, G., & Brodie, M. (2016). The burden of medical debt: results from the Kaiser Family Foundation/New York Times Medical Bills Survey - Section 1: Who has medical bill problems and what are the contributing factors? Retrieved October 24, 2016, from http://kff.org/report-section/the-burden-of-medical-debt-section-1-who-has-medical-bill-problems-and-what-are-the-contributing-factors/.
Hardee, J. T., Platt, F. W., & Kasper, I. K. (2005). Discussing health care costs with patients. Journal of General Internal Medicine, 20(7), 666–669.
Kieran, S., Loescher, L. J., & Lim, K. H. (2007). The role of financial factors in acceptance of clinical BRCA genetic testing. Genetic Testing, 11(1), 101–110.
Klitzman, R., Chung, W., Marder, K., Shanmugham, A., Chin, L. J., Stark, M., et al. (2012). Attitudes and practices among internists concerning genetic testing. Journal of Genetic Counseling, 22(1), 90–100.
Kopits, I. M., Chen, C., Roberts, J. S., Uhlmann, W., & Green, R. C. (2011). Willingness to pay for genetic testing for Alzheimer's disease: a measure of personal utility. Genetic Testing and Molecular Biomarkers, 15(12), 871–875.
Lane, M., Ngueng Feze, I., & Joly, Y. (2015). Genetics and personal insurance: the perspectives of Canadian cancer genetic counselors. Journal of Genetic Counseling, 24(6), 1022–1036.
Leonhard, J. R., Munson, P. J., Flanagan, J., De Berg, K. L., Thompson, P. A., Dean, L. W., & Stein, Q. P. (2017). Analysis of reimbursement of genetic counseling services at a Single Institution in a state requiring licensure. Journal of Genetic Counseling, 26(4), 852–858.
Matro, J. M., Ruth, K. J., Wong, Y. N., McCully, K. C., Rybak, C. M., Meropol, N. J., & Hall, M. J. (2014). Cost sharing and hereditary cancer risk: predictors of willingness-to-pay for genetic testing. Journal of Genetic Counseling, 23(6), 1002–1011.
NSGC (2014). Professional Status Survey. Retrieved May 11, 2014 from http://nsgc.org/p/do/sd/sid=14&type=0
Tilburt, J. C., Wynia, M. K., Sheeler, R. D., Thorsteinsdottir, B., James, K. M., Egginton, J. S., et al. (2013). Views of US physicians about controlling health care costs. JAMA, 310(4), 380–388.
Ubel, P. A., Abernethy, A. P., & Zafar, S. Y. (2013). Full disclosure -- out-of-pocket costs as side effects. The New England Journal of Medicine, 369(16), 1484–1486 Retrieved from http://search.proquest.com/docview/1442702520?accountid=142023.
Veach, P. M., Bartels, D. M., & LeRoy, B. S. (2007). Coming full circle: a reciprocal engagement model of genetic counseling practice. Journal of Genetic Counseling, 16(6), 713–728. https://doi.org/10.1007/s10897-007-9113-4.
Acknowledgements
The undertaking of this study, collection of data, and statistical analyses were completed to fulfill a degree requirement for the University of Arkansas for Medical Sciences’ Genetic Counseling Graduate Program.
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Shelby Brown, Susan Puumala, Jennifer Leonhard, Megan Bell, Lori Williamson Dean, Jason Flanagan & Quinn Stein declare that they have no conflict of interest.
Human Studies and Informed Consent
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all individual participants included in the study.
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No animal studies were carried out by the authors for this article.
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Brown, S., Puumala, S., Leonhard, J. et al. Genesurance Counseling: Genetic Counselors’ Roles and Responsibilities in Regards to Genetic Insurance and Financial Topics. J Genet Counsel 27, 800–813 (2018). https://doi.org/10.1007/s10897-017-0180-x
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DOI: https://doi.org/10.1007/s10897-017-0180-x