DBS Testing for Health Plans: Closing Care Gaps | Ash

For health plans and managed care organizations, the challenge of closing care gaps often comes down to one barrier: the "last mile" of preventive screening. Traditional phlebotomy requires members to visit a lab, take time off work, and navigate transportation—hurdles that frequently lead to non-compliance.

Dried blood spot testing is a determined, reliable alternative that brings the lab to the member. By utilizing a dry blood spot card, payers can facilitate high-quality clinical screening for infectious diseases, chronic conditions, and metabolic health without the need for a clinical visit.

What is Dried Blood Spot Collection?

Dried blood spot collection is a minimally invasive method of gathering capillary blood. Unlike traditional venipuncture, which requires a phlebotomist to draw several milliliters of "wet" blood, DBS utilizes a simple finger prick.

While the core technology involves drying blood on a fibrous matrix, the choice of collection device can impact program design. Two commonly used types of dry blood cards include:

• Whatman 903 Cards: A well-established standard in clinical testing. These cards are highly stable, with approximately 95% of biochemical compounds remaining stable after three weeks of storage at room temperature.
• ADx100 Cards: These specialized microfluidic devices use patterned filter paper to handle capillary blood samples. They are frequently utilized for cardiovascular risk screenings and lipid panels because they can stabilize specimens at room temperature for extended periods.

The process is straightforward:

1. Collection: The member pricks their finger using a lancet and blots small droplets of blood onto the pre-marked circles of a dry blood spot card.
2. Drying: The blood is left to air dry for 1–2 hours, which stabilizes the sample in a fibrous matrix for room-temperature transport.
3. Extraction: Once at a CLIA/CAP-certified lab, technicians "punch" the spots and elute them into a solvent to extract target analytes for analysis.

Ensuring Quality: DBS Testing Accuracy

A common question among Clinical Directors and CMOs is whether a finger-prick sample can match the reliability of a venous draw. Meta-analyses of diagnostic accuracy consistently confirm the high performance of DBS.

A comprehensive systematic review of 174 studies found that DBS specimens demonstrate high sensitivity and specificity across a wide range of conditions. 

While dual infections (such as HIV/HCV co-infection) can sometimes influence assay sensitivity, individual laboratory validation of test cut-offs ensures that DBS remains a scientifically rigorous tool for population health surveillance.

Why Fingerprick Diagnostics Benefit Rural Populations and Increase Health Equity

Fingerprick diagnostics break down the racial and socioeconomic care gaps that often plague traditional healthcare models. According to the JAMA Network, individuals with lower socioeconomic status are more likely to experience gaps in care when physical lab visits are required. Similarly, rural populations often lack the time and resources for in-lab visitations.

By removing the "cold chain" requirement—DBS cards do not require refrigeration or stabilizers—public health street teams and health plans can reach hard-to-access populations more cost-effectively than ever before.

Leveraging a DBS Card Program for Payers

For DBS card program payers, the utility extends far beyond convenience. It is a cost-effective strategic tool for population health management.

Closing HEDIS and Star Ratings Care Gaps

Quality metrics like HEDIS and Medicare Star Ratings are the lifeblood of a health plan’s reputation and reimbursement. At-home testing for health plans via DBS directly impacts several key measures:

• Diabetes Care (HbA1c Testing): HEDIS and Star Ratings prioritize blood sugar control. Remote dried blood spot testing allows members to submit HbA1c samples from home, ensuring regular monitoring even for rural or homebound populations.
• Medication Adherence (PrEP & Statins): Programs like ongoing STI testing and suitability monitoring for GLP-1s (like our partnership with Noom) utilize dried blood spot cards to ensure timely and convenient testing - boosting medication adherence.
• Kidney Health & Cardiovascular Screening: Plans can track Glomerular Filtration Rate (GFR) for diabetes patients or monitor lipid panels (HDL, LDL, Triglycerides) to prevent high-cost cardiovascular events.

Partner with Ash

At Ash, we provide the end-to-end infrastructure to launch at-home testing for health plans in a matter of weeks. With a menu of 150+ diagnostic tests, a national CLIA/CAP lab network, and seamless API integration, we help you turn care gaps into points of engagement.

If you’d like to talk more about Ash’s at-home testing programs, learn about alternative solutions (like the wet-blood collection Tasso device), or understand the ROI of at-home testing, you can contact us here.