Aeron LifeCycles Laboratory
Practitioner Survey Results- January 2004

"Do you recommend that your patients over 45 years monitor their hormone levels?"

	65% of those responding (n=286) test their perimenopausal and menopausal patients annually
	25% recommend testing every two years
	10% only recommend testing a patients' hormone levels when they complain

"After a patient begins HRT, when do you suggest a follow-up hormone test to adjust/confirm their dose?'

	12% of healthcare providers recommend a follow-up hormone test, 2-4 weeks after starting HRT
	79% recommend a follow-up test 2-6 months after beginning HRT
	9% of practitioners recommend a follow up test ONLY if the patient complains (a large percentage would recommend testing earlier than usual if the patient had negative symptoms i.e. complained)

"Urine bone markers for the rate of bone loss (Dpd) should be used to identify patients who may be at risk for osteoporosis." 

	22% use the bone marker to identify at risk patients beginning at about 45 years old
	41% recommend the urine Dpd assay for patients with a family history of osteoporosis
	37% utilize the urinary bone marker after patients have had a poor bone scan

What might encourage a practice to recommend hormone testing to more patients?

Insurance Coverage
Aeron has contracts with and will bill directly for Blue Cross, Blue Shield, United Healthcare and Medicare. The provider must be a Medicare provider (have a UPIN number) and must provide the appropriate ICD-9/diagnosis code. Even if you do not accept the above insurance in your practice, Aeron will. Other PPO and POS insurance will usually reimburse the patient a portion of the laboratory costs (60% is fairly standard for out of network reimbursement). HMO's outside of Blue Cross, Blue Shield and United Healthcare would not cover testing since Aeron is not in their network. Coverage for hormone testing would be the same whether you were testing on serum, saliva or urine. It is specific to the hormone, the medical provider ordering and the testing facility.

Physician Education
We are updating our Professional Guide and the Interpretation Guide. We are including more of the information gained from 10+ years as a salivary hormone testing laboratory. Aeron believes in leaving the doctoring to the doctor but we are more than happy to share our experiences with testing, results, and the pharmacokinetics of different delivery systems. Aeron's President - John Kells, would enjoy talking with you at your convenience. Call your account representative to set up a date and time.

Many practitioners also requested more information on the Dpd urinary bone marker for the rate of bone loss. We will be sending updated information on the interpretation and usefulness of this assay. Medicare recommends this assay for all patients over 50 years - regardless of bone scan results or family history. It is so important to identify a high rate of bone loss early when intervention is patient friendly (dietary, exercise, hormone support).

Patient Brochures and Displays
Aeron has these. Three different patient brochures and table top displays. Hormonal Portraits talks about the benefits of saliva testing, the different hormones to be tested and why, insurance coverage and contact information. The Transitions brochure discusses perimenopause, hormone fluctuations, which hormones to look at and timing. Then there is the "Are You a Bone Loser?" brochure about the urine bone marker for the rate of bone loss.

Miscellaneous

	Yearly reminders to the patient to follow up with a hormone test
	Increase in patient demand for testing
	Multiple testing discounts for private pay patients
	Simplified collection instructions