Healthcare Costs Rising, Home Testing May Be An Answer

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The story of Theranos is a cautionary tale regarding health related self-testing and a lesson learned is to do some research before you trust the tests and reputation of a company.

Having said that, their story shouldn’t taint an industry that is helping millions save money by self-testing than paying the higher cost of going to labs and paying out of pocket for their services.

Theranos is an American privately held health technology company based in Palo Alto, California. The company is known for its marketing of its efforts to create blood tests that used small sample volume technology. It was founded in 2003 by Elizabeth Holmes at the age of 19.

In July 2016, Theranos received sanctions from the Centers for Medicare & Medicaid Services (CMS) including the revocation of its CLIA certificate and prohibition of the owners and operators from owning or operating a lab for two years.

The Wall Street Journal investigative reporter John Carreyrou was responsible for uncovering and exposing “that the company was, in effect, a sham”.

For this he received the 67th annual George Polk Awards in Journalism for Financial Reporting (2015). He will be publishing a book-length treatment in 2018 titled Bad Blood, and a film version is in the works starring Jennifer Lawrence as Elizabeth Holmes, to be directed by Adam McKay.

Home testing may be in your best interest and we have a visiting Internist with some suggestions to help you find the balance in moving forward with what is best for you.

Victor Battles is a board-certified internist who graduated from University of Pennsylvania Medical School. He was in solo practice in Fort Worth Texas for 20 years. He is currently a disability consultant.

The Benefits of Home Test Kits

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By Victor Battles 

Home test kits should not be totally relied upon as a substitute for a CLIA approved laboratory, but in certain settings they provide advantages over traditional laboratory testing. These advantages can reduce healthcare costs, provide peace of mind and be instrumental in improving health and improving healthcare.

One of the major advantages of the kits is the convenience they provide particularly for individuals who are homebound for various reasons including illness, limited funds, or lack of transportation. Home test kits can be ordered online and are shipped to your home.  The test results are obtained within minutes after following directions that come with the kit or in the case of a test requiring interpretation by reference lab, the results are mailed to you in a few days in most cases. Tests traditionally performed by laboratories usually require a needle stick and the removal of a modest to moderate amount of blood from a vein which might be painful depending on the technique and proficiency of the phlebotomist. With the use of a home kit however, only a small amount of blood from a finger puncture is needed and is generally much better tolerated than the puncture of a vein.  Many of the home tests don’t require collection of blood at all, but the collection of urine, hair or saliva instead.

The safety of the specimen collection hinges not only upon the technique and the proficiency of the person that collects it, but also on the environment in which the specimen is collected.  It is a well-known fact that environments frequented by sick people generally harbor more germs (primarily viruses and bacteria), particularly during the height of flu season and which will certainly be the case in the event of a flu pandemic. Not having to go to a laboratory or doctor’s office to have a test specimen collected substantially reduces exposure to infectious disease producing viruses and bacteria which might be of major importance if you have a condition which lowers your immunity.

Home test kits also provide privacy and confidentiality of test results which is particularly important for individual who live in small communities where discussions in doctor’s offices sometimes become community knowledge. This is especially true with respect to tests for sexually transmitted diseases, illegal drug use and paternity. Many are also concerned about test results ending up in a national databank which does not happen in the case of home testing.

With the burgeoning illegal drug epidemic that is plaguing our society today, a home drug testing program might be the only way of ensuring a drug free home and the linchpin of family stability, particularly if you have teenagers. Drug test kits enable you to implement and enforce a Parent and Teen Drug Free Home Agreement which could prove priceless in terms of the future direction of your family.[adToAppearHere]

Home testing might also be a good initial step in helping you decide on the type of group health insurance plan you select if you have not recently been to a doctor and are concerned that you might have a particular illness which has not been diagnosed. This is important because many of the PPO and other non-HMO insurance plans have pre-existing illness exclusions which are not covered for a specified period of time or are not covered at all once the policy goes into effect. If you discover that you do probably have a particular condition based on home test result that could very well be the deciding factor in whether or not you select an HMO or PPO insurance plan. If you are planning to purchase your own insurance home testing prior to the application might be of value in validating your answers to questions on the insurance application questionnaire, and might spare you the unexpected pre-existing illness exclusions(s) if your application is approved.

The use of a home testing kit can provide peace of mind regarding environment concerns and can be instrumental in diagnosing disease related to home environment hazards such as exposure to radon gas, lead and other heavy metals.  Routine screening for these health hazards is not a part of traditional medical practice because environmental safety is not emphasized in medical training and screening tests to diagnose illnesses related to them are not routinely covered by insurance companies. The health-insurance industry reimburses based on a coding system. Services, including doctor visits and laboratory testing have specified service codes or CPT codes. When a claim for reimbursement is submitted to an insurance company by your doctor, laboratory or other healthcare provider the insurance company is informed of the reason(s) the service was provided via diagnosis codes known as ICD-9-CM codes. If a carrier processes a claim in which a listed service code is not justified by an appropriate ICD-9-CM diagnosis code, the claim is denied and the recipient of the service (the patient) is billed. Given customary laboratory fees, that charge most likely will be significantly greater than the cost of a test kit to perform a comparable test.  If a diagnosis is made by use of a test kit and additional future testing for that same problem is required the relevant ICD-9-CM code can then be submitted with futures claims to the insurance carrier and who should then pay the claim. A negative environmental safety home test on the other hand can provide peace of mind that you don’t the home environmental hazard test for.[adToAppearHere]

Finally, home testing can be a bridge between not having health insurance and obtaining healthcare. An example is participation in clinical research trials which afford great opportunities for individuals to receive medical care who otherwise would not be able to afford the care. All clinical trials have what are known as inclusion criteria which include the diagnosis among other variables that have to be met in order to be a participant in the trial. A condition which is diagnosable via home test kit might be the necessary data for screening and eventual enrollment in a clinical trial.  Social Security disability benefits are also an avenue for individuals without health insurance coverage to obtain coverage if deemed disabled following a disability determination evaluation. Many of the evaluations are performed however without applicants having established diagnoses because their inability to afford to see a doctor and have tests performed.  It stands to reason that, if for example an applicant filing for disability due to fatigue has an accompanying diagnosis of AIDS or hepatitis C, whether the diagnosis was made via traditional laboratory testing or from the use of a home kit, the likelihood of obtaining disability benefits would be greater.

In summary, home test kits provide convenience and safety of the testing process, confidentiality of the test results, increased likelihood of a drug free home, and peace of mind with respect to concerns about possible home environmental hazards. Additionally the kits might diagnose problems that would otherwise go undiagnosed and can be of benefit in obtaining medical care, whether it is in the form participation in a clinical trial or the acquisition of health insurance.[adToAppearHere]

Being a board-certified internist I am well aware of the role that lab testing plays in evaluating patients and providing appropriate health care.

To learn more about test kits, how you can use them as a supplement to your health care and improving your health, and to choose from a variety of quality kits visit

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