ETS Provides Cell & Gene Access With A Single Point-of-Contact
More patients are accessing a growing number of newly-approved cell and gene therapies, plus transplants and other complex and high-cost specialty treatments – many for unfamiliar conditions not previously treatable. Emerging Therapy Solutions® (ETS) offers providers a simplified contracting process and program promotion by leveraging its relationships with national payers, jumbo employers, and other risk-bearing entities.
Emerging Therapy Outlook
By the end of 2026, ETS estimates that there will be over 50 complex or rare indications* for which new cell and gene therapies will be available. With therapy biologic costs ranging from $338k to $4.25 million, and administration costs ranging from $300k to $800k, individual treatment claim costs will increase exponentially leading to greater expense, outlay, and risk for you.
Emerging Therapy Solutions was founded because of this growth in treating rare and complex medical conditions. We help our clients manage the immense risk, costs and intricate processes associated with these treatments.
As a recognized leader in cell and gene therapy, and stem cell and solid organ transplant services, ETS focuses on providing expert clinical content, payer education, and access to negotiated, contracted rates at qualified centers.
A Simplified
Contracting Process
We do the heavy lifting by minimizing administrative burden through:
- Specialized contracting for specialty services
- Close monitoring and consistent communication from start to finish
- Quick claim turnaround times
- Experts in single-case agreements for newly approved therapies
- Simplified Medicare/Medicaid payment methodology
Uncovering More
Qualified Patients
We educate payers and employers, about cell and gene therapies and the associated conditions with:
- Medical policy language
- Coverage and care information
- Pipeline forecast modeling to identify patients in need of care
ETS is uniquely positioned to facilitate access to cell and gene therapies and other complex care.
Building Provider
Program Awareness
ETS fosters connection by promoting programs and providers to payer clients, including:
- Listing in ETS proprietary online Referral Center client portal for 24/7 client selection
- Listing on ETS public website
- Program promotion to ETS clients in monthly newsletters & quarterly client webinars
- Opportunity to present to ETS clients in educational webinars or participate in ETS expert panels
The ETS Difference
Provider Program Awareness, Nationwide Reach & Simplicity
- Referrals from ETS’ nationwide client membership is based on established payer relationships – ETS contracts with over 90% of US stop-loss carriers and reinsurers.
- ETS membership spans almost a quarter of the US population and offers clients and providers a single-point-of-contact clinical lead for accessing specialty services (transplant, cell and gene therapy) – The number of lives represented by ETS has grown 300% to 80M.
- Flexible referral notifications based on facility preference.
- Dedicated claims repricing unit that provides accurate and efficient claims repricing for timely payment.
- A specialized ‘bundled’ approach to contracting for the entire treatment experience for the therapy or transplant being administered.
- ETS’ nationwide Programs of Excellence and Programs of Experience model offers providers the opportunity for designation in our program guides and secure online client Referral Center.
Why Providers Work with ETS
By partnering with ETS, work with a business that offers:
- Collaboration – Because ETS is not a direct payer, we take a broader view and leverage our extensive experience for optimal results
- Complex case expertise – ETS is highly specialized in the navigation and processing of complex cases – this is what we do
- Availability – Seasoned claims team provides simplified, efficient, and accurate contracting and claims processing experience
- A connected network – ETS is at the center of industry, payor and provider communities allowing full line-of-site. ETS also leads the charge on complex clinical education and marketing through our knowledge center expert content, data models, and expert physician panel insights.
