In September 2021, Michigan became the first state to establish Medicaid coverage of rWGS for critically ill infants who meet certain criteria through a carve-out reimbursement separate from the Diagnosis Related Group (DRG) payment.

“Ever since the legislation passed, I’ve been particularly touched by the number of calls that I am getting from other physicians, working in states like Oregon and Washington, wanting to know the connections and conversations we had, as well as the evidence that was most impactful, to make this a reality,” said Dr. Bupp. “It has really started to snowball!”

Now Dr. Bupp and others are moving on to the next phase of Project Baby Deer. They recently completed an implementation study to determine how much healthcare providers understood about genomics and rWGS, if they felt the testing was useful, and whether it changed their care management. Views about rWGS were generally positive and greatly influenced by a provider’s knowledge about the testing. Based on survey results from the study, published in the March 2022 issue of Children, the PBD team plans to focus on providing state-wide targeted education to providers and track to see if their level of understanding and utilization has increased. Additionally, Dr. Bupp is collaborating with medical centers throughout Michigan to learn how they are handling the reimbursement process for rWGS, because this has never been done before, and develop a standardized workflow to optimize the process.

“When you think about health equity, it shouldn’t matter where a kid is born as to whether they can get lifesaving testing like rWGS – it should be available for kids everywhere,” said Dr. Bupp.