Oct 7, 201502:08 PMVan Lines
with Joe Vanden Plas
Alders, it’s no time to jump off Exact Sciences’ ledge
(page 2 of 2)
In a conference call with investors and market analysts, Conroy vowed to work with the task force through its public comment period and convince it to modify its draft guidance and include Cologuard as one of the recommended screening strategies. That’s worth the effort, especially since more than 20 commercial health insurers already cover Cologuard. Those 20 insurers represent 57% of the covered population.
However, it’s not the only factor local decision makers should consider.
Once the heat of the moment subsides, the stock price could recover from the beating it took on Tuesday, when the company’s share price dropped precipitously from its Monday closing of $18.53.
Moreover, the company, noting that early adoption of Cologuard remains strong, hasn’t backed off his commitment to adding 400 new jobs by 2019. Thus far, physicians have ordered more than 100,000 tests, which represents a strong product launch.
One thing to watch for is a final determination by the Centers for Medicare and Medicaid Services (CMS) on maintaining the current reimbursement rate for Cologuard. Last week, CMS issued a preliminary determination to maintain the current rate, and it also announced a new CPT billing code for Cologuard. Medicare and commercial payers use CPT codes to facilitate the processing of claims.
CMS is expected to issue its final decision in November for rates that will be effective on Jan. 1, 2016.
If the timing works out — remember, Exact Sciences would like to begin development in Judge Doyle Square by year’s end — it would also be a good idea to see if Cologuard is included in quality measures like HEDIS (Healthcare Effectiveness Data and Information Set). As Conroy notes, inclusion in those quality measures drives physician utilization and behavior, and payers want to be able to advertise to their large-employer customers that they have high-quality metrics.
So while all the focus is on panicky investors, how about taking a breath to see what CMS, insurers, doctors, and patients think?
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