Breakout Dx player Theranos keys into Medicaid with latest deal in managed care

Theranos CEO Elizabeth Holmes

Theranos has major ambitions--and, if you glance at the composition of its board, it's obvious that diagnostics cost-savings on the massive scale of the U.S. government is at the core of them. Now, it's made a first partnership that moves it toward realizing that goal. It will offer diagnostic testing through managed care provider AmeriHealth Caritas, which serves more than 6.6 million patients across 16 states and the District of Columbia--the bulk of whom are on Medicaid.

The long-stealthy Theranos has broken out in the last few weeks with a stream of news including its first FDA approval--it's committed to running all its tests through the agency--as well as its first deal with a healthcare insurer. The diagnostics player is now reportedly worth about $10 billion, making it perhaps the most highly valued life sciences companies that remains private.

"Our goal is to give the disadvantaged in our country--the poor, the chronically ill--the dignity and respect that comes with having a health care experience comparable to what most Americans enjoy--an experience based on an informed, consultative relationship with a health care professional," Paul Tufano, chairman and CEO of AmeriHealth Caritas, said on the Theranos partnership in a statement.

He continued, "Our hope is that, equipped with reliable, real-time information gained through Theranos' innovative technology and accessible model, our members will be more likely to engage with a physician and make timely health care decisions, as well as develop a comprehensive care plan for living a healthier life."

Under the deal, AmeriHealth Caritas members will have access to physician-directed laboratory diagnostic testing provided by Theranos. Its technology allows a blood sample for testing to be taken with a finger stick or another micro-sample method, rather than the typical vial of blood that requires technicians to draw it. Its results are also available faster--in a matter of hours rather than days or even weeks--as well as substantially cheaper, according to the company

Theranos claims to be the first diagnostic lab to publish its pricing--and it says its tests cost at least 50% less than the Medicare reimbursement rate. So, the deal could translate into significant savings for AmeriHealth Caritas, given its Medicaid-heavy patient population.

The board of directors at Theranos includes a who's who of retired U.S. lawmakers, admirals and generals--at least 8 of its members are former U.S. government heavyweights including former Secretary of State Henry Kissinger, former Senate Majority leader William Frist and former Center for Disease Control and Prevention (CDC) director William Foege. That line-up suggests that any healthcare organization that touches the U.S. government, including the obvious ones such as the Veterans Administration and CMS, will be fair game for Theranos.

"Over 40% of lab test orders don't get filled because testing services are inconvenient and cost too much. Improved access is the best way to help save lives, because access to information puts the focus on earlier detection and prevention instead of diagnosis and treatment." said Theranos founder and CEO Elizabeth Holmes in a statement. "AmeriHealth Caritas has lived this mission of serving Medicaid for more than a quarter of a century. They are a national leader in Medicaid managed care, committed to improving the health of underserved and chronically ill populations."

She added, "At Theranos, we believe access to actionable health information to protect our own health and that of those we love is a basic human right."

- here is the release

Special Report: Top women in medical devices 2014 - Elizabeth Holmes, Theranos

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