Nilsen, Conrad
(2024)
Insurance Coverage for Genetic Testing in Puerto Rico: A Comparative Analysis.
Master Essay, University of Pittsburgh.
Abstract
Genetic testing is pivotal in modern healthcare, enabling personalized treatment strategies and early disease detection. However, disparities in insurance coverage for genetic testing can impede access to these crucial services. The New York Mid-Atlantic Caribbean (NYMAC) Regional Genetics Network collaborates with stakeholders in Puerto Rico to improve access to genetic services. This study examines coverage for genetic testing in Puerto Rico by analyzing health insurance benefits from major Puerto Rican commercial insurers. Data were sourced from insurance summary of benefits documents and clinical molecular testing criteria. Coverage areas included general genetic services, common testing indications (e.g., autism, hereditary cancers), reproductive genetic concerns, and rare diseases specific to Puerto Rico. Comparison with mainland U.S. commercial insurers revealed gaps between mainland U.S. and Puerto Rican insurance policies. While mainland U.S. insurers provided detailed criteria for genetic testing, Puerto Rican policies contained limited information, or the medical policies were so convoluted that it was difficult to ascertain whether specific tests would be covered. There is also a significant gap in coverage for carrier screening, which is particularly relevant given the region’s unique genetic profile. NYMAC and other public health genetics-focused organizations can use the information gained from this analysis as a starting point to conduct further assessments to highlight health equity gaps and policy needs. This work is of great public health importance as it underscores a health equity issue that requires policy change around genetic testing coverage in Puerto Rico and describes potential solutions.
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| Item Type: |
Other Thesis, Dissertation, or Long Paper
(Master Essay)
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| Contributors: |
| Contribution | Contributors Name | Email | Pitt Username | ORCID  |
|---|
| Committee Chair | Durst, Andrea | adurst@pitt.edu | adurst | UNSPECIFIED | | Committee Member | Terry, Alissa | alissa.bovee@gmail.com | UNSPECIFIED | UNSPECIFIED | | Committee Member | Savitz, Lucy | LASavitz@pitt.edu | LASavitz | UNSPECIFIED |
|
| Date: |
21 May 2024 |
| Date Type: |
Completion |
| Submission Date: |
14 May 2024 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
48 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Public Health Genetics |
| Degree: |
MPH - Master of Public Health |
| Thesis Type: |
Master Essay |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
genetic testing, insurance coverage, Puerto Rico |
| Date Deposited: |
21 May 2024 13:51 |
| Last Modified: |
21 May 2024 13:51 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/46410 |
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