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Purpose: To learn the extent to which HMOs and academic genetic centers (1) are involved in predictive genetic tests for common, complex disorders and (2) interact with each other. Methods: Surveys of HMO medical directors and directors of U.S. academic genetic centers. Results: In 1996, approximately 28|X% of HMOs were covering predictive tests for breast and colon cancer, but 75|X% of all medical directors said their HMO would consider policies regarding predictive testing in the next 5 years. Approximately 80|X% of directors of academic genetic centers said they provided genetic counseling services for common adult-onset disorders for patients covered by managed care organizations (MCOs), but they ranked the volume of services they provide for pediatric and prenatal indications much higher. Most academic genetic centers (72|X%) have contracts with MCOs. Conclusion: Although genetic services are being provided by academic genetic centers to patients who are members of managed care organizations, many patients with whom genetic testing for adult onset disorders is discussed may never see a geneticist. Academic genetic centers should educate nongeneticist professionals about the use of tests for common disorders.