Value of waiving coinsurance for colorectal cancer screening in medicare beneficiaries

Health Affairs

Volumn 36, Issue 12, 2017, Pages 2151-2159

  Peterse, Elisabeth F P ^a   Meester, Reinier G S ^a   Gini, Andrea ^a   Doubeni, Chyke A ^b   Anderson, Daniel S ^c   Berger, Franklin G ^d   Zauber, Ann G ^e   Lansdorp Vogelaar, Iris ^e  

^a ERASMUS MEDICAL CENTER   (Netherlands)

^b UNIVERSITY OF PENNSYLVANIA   (United States)

^c KAISER PERMANENTE   (United States)

^d UNIVERSITY OF SOUTH CAROLINA   (United States)

^e MEMORIAL SLOAN KETTERING CANCER CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGED; ARTICLE; CANCER MORTALITY; CANCER SCREENING; CLINICAL EVALUATION; COLONOSCOPY; COLORECTAL CANCER; COLORECTAL POLYP; COLORECTAL SURGERY; COMPARATIVE STUDY; COST EFFECTIVENESS ANALYSIS; DISEASE SURVEILLANCE; FOLLOW UP; HEALTH CARE COST; HEALTH INSURANCE; HUMAN; MAJOR CLINICAL STUDY; MEDICAID; MEDICARE; OCCULT BLOOD TEST; POLYPECTOMY; QUALITY ADJUSTED LIFE YEAR; REIMBURSEMENT; SCREENING TEST; COLORECTAL TUMOR; COST; COST BENEFIT ANALYSIS; EARLY CANCER DIAGNOSIS; ECONOMICS; FEMALE; MALE; MASS SCREENING; OCCULT BLOOD; PROCEDURES; STATISTICS AND NUMERICAL DATA; TRENDS; UNITED STATES;

AGED; COLONOSCOPY; COLORECTAL NEOPLASMS; COST-BENEFIT ANALYSIS; DEDUCTIBLES AND COINSURANCE; EARLY DETECTION OF CANCER; FEMALE; HUMANS; MALE; MASS SCREENING; MEDICARE; OCCULT BLOOD; UNITED STATES;

EID: 85046793316     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2017.0228     Document Type: Article

References (41)

1. American Cancer Society. Cancer Statistics Center, Colorectum: at a glance [Internet]. Atlanta (GA): ACS; c 2017 [cited 2017 Oct 11]. Available from: https://cancerstatisticscenter .cancer.org/?_ga=1.33682849.18 77282425.1465291457#!/cancersite/ Colorectum
2. US Preventive Services Task Force. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA. 2016;315(23):2564-75
3. Holme Ø, Bretthauer M, Fretheim A, Odgaard-Jensen J, Hoff G. Flexible sigmoidoscopy versus faecal occult blood testing for colorectal cancer screening in asymptomatic individuals. Cochrane Database Syst Rev. 2013;(9):CD009259
4. Senore C, Inadomi J, Segnan N, Bellisario C, Hassan C. Optimising colorectal cancer screening acceptance: a review. Gut. 2015;64(7): 1158-77
5. Jones RM, Woolf SH, Cunningham TD, Johnson RE, Krist AH, Rothemich SF, et al. The relative importance of patient-reported barriers to colorectal cancer screening. Am J Prev Med. 2010;38(5): 499-507
6. Sommers BD, Gunja MZ, Finegold K, Musco T. Changes in self-reported insurance coverage, access to care, and health under the Affordable Care Act. JAMA. 2015;314(4):366-74
7. Hamman MK, Kapinos KA. Colorectal cancer screening and state health insurance mandates. Health Econ. 2016;25(2):178-91
8. Richman I, Asch SM, Bhattacharya J, Owens DK. Colorectal cancer screening in the era of the Affordable Care Act. J Gen Intern Med. 2016; 31(3):315-20
9. Wharam JF, Zhang F, Landon BE, LeCates R, Soumerai S, Ross-Degnan D. Colorectal cancer screening in a nationwide high-deductible health plan before and after the Affordable Care Act. Med Care. 2016;54(5): 466-73
10. Fedewa SA, Goodman M, Flanders WD, Han X, Smith RAM, M Ward E, et al. Elimination of cost-sharing and receipt of screening for colorectal and breast cancer. Cancer. 2015; 121(18):3272-80
11. Hamman MK, Kapinos KA. Affordable Care Act provision lowered out-of-pocket cost and increased colonoscopy rates among men in Medicare. Health Aff (Millwood). 2015;34(12):2069-76
12. Howard DH, Guy GP Jr, Ekwueme DU. Eliminating cost-sharing requirements for colon cancer screening in Medicare. Cancer. 2014; 120(24):3850-2
13. Van Hees F, Habbema JD, Meester RG, Lansdorp-Vogelaar I, van Ballegooijen M, Zauber AG. Should colorectal cancer screening be considered in elderly persons without previous screening? A cost-effectiveness analysis. Ann Intern Med. 2014;160(11):750-9
14. Lansdorp-Vogelaar I, van Ballegooijen M, Zauber AG, Habbema JD, Kuipers EJ. Effect of rising chemotherapy costs on the cost savings of colorectal cancer screening. J Natl Cancer Inst. 2009; 101(20):1412-22
15. National Cancer Institute. Cancer Intervention and Surveillance Modeling Network: colorectal cancer model profiles [Internet]. Bethesda (MD): NCI; [cited 2017 Sep 27]. Available from: https://cisnet .cancer.gov/colorectal/profiles.html
16. Zauber AG, Lansdorp-Vogelaar I, Knudsen AB, Wilschut J, van Ballegooijen M, Kuntz KM. Evaluating test strategies for colorectal cancer screening: a decision analysis for the U.S. Preventive Services Task Force. Ann Intern Med. 2008; 149(9):659-69
17. Knudsen AB, Zauber AG, Rutter CM, Naber SK, Doria-Rose VP, Pabiniak C, et al. Estimation of benefits, burden, and harms of colorectal cancer screening strategies: modeling study for the US Preventive Services Task Force. JAMA. 2016; 315(23):2595-609
18. To access the Appendix, click on the Details tab of the article online
19. National Center for Health Statistics. National Health Interview Survey [Internet]. Hyattsville (MD): NHIS; [last updated 2017 Sep 21; cited 2017 Sep 27]. Available from: http:// www.cdc.gov/nchs/nhis.htm
20. Sabatino SA, White MC, Thompson TD, Klabunde CN. Cancer screening test use-United States, 2013. MMWR Morb Mortal Wkly Rep. 2015;64(17):464-8
21. Centers for Disease Control and Prevention. Vital signs: colorectal cancer screening test use-United States, 2012. MMWR Morb Mortal Wkly Rep. 2013;62(44):881-8
22. Lieberman DA, Rex DK, Winawer SJ, Giardiello FM, Johnson DA, Levin TR. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2012;143(3):844-57
23. CMS.gov Clinical laboratory fee schedule files [Internet]. Baltimore (MD): Centers for Medicare and Medicaid Services; [last modified 2016 Sep 29; cited 2017 Sep 27]. Available from: https://www.cms .gov/Medicare/Medicare-Fee-for-Service-Payment/ClinicalLab FeeSched/Clinical-Laboratory-Fee-Schedule-Files.html
24. Yabroff KR, Lamont EB, Mariotto A, Warren JL, Topor M, Meekins A, et al. Cost of care for elderly cancer patients in the United States. J Natl Cancer Inst. 2008;100(9):630-41
25. Colquhoun P, Chen HC, Kim JI, Efron J, Weiss EG, Nogueras JJ, et al. High compliance rates observed for follow up colonoscopy post polypectomy are achievable outside of clinical trials: efficacy of polypectomy is not reduced by low compliance for follow up. Colorectal Dis. 2004;6(3):158-61
26. Shaukat A, Mongin SJ, Geisser MS, Lederle FA, Bond JH, Mandel JS, et al. Long-term mortality after screening for colorectal cancer. N Engl J Med. 2013;369(12):1106-14
27. Khatami S, Xuan L, Roman R, Zhang S, McConnel C, Halm EA, et al. Modestly increased use of colonoscopy when copayments are waived. Clin Gastroenterol Hepatol. 2012; 10(7):761-766.e1
28. Grosse SD. Assessing cost-effectiveness in healthcare: history of the $50, 000 per QALY threshold. Expert Rev Pharmacoecon Outcomes Res. 2008;8(2):165-78
29. Oliphant R, Brewster DH, Morrison DS. The changing association between socioeconomic circumstances and the incidence of colorectal cancer: a population-based study. Br J Cancer. 2011;104(11):1791-6
30. Cubanski J, Swoope C, Boccuti C, Jacobson G, Casillas G, Griffin S, et al. A primer on Medicare: key facts about the Medicare program and the people it covers [Internet]. Menlo Park (CA): Henry J. Kaiser Family Foundation; 2015 Mar 20 [cited 2017 Sep 27]. Available from: http:// kff.org/report-section/a-primeron-medicare-what-types-ofsupplemental-insurance-dobeneficiaries-have/
31. Han X, Robin Yabroff K, Guy GP Jr, Zheng Z, Jemal A. Has recommended preventive service use increased after elimination of costsharing as part of the Affordable Care Act in the United States? Prev Med. 2015;78:85-91
32. Cooper GS, Kou TD, Schluchter MD, Dor A, Koroukian SM. Changes in receipt of cancer screening in Medicare beneficiaries following the Affordable Care Act. J Natl Cancer Inst. 2015;108(5)
33. Mehta SJ, Polsky D, Zhu J, Lewis JD, Kolstad JT, Loewenstein G, et al. ACA-mandated elimination of cost sharing for preventive screening has had limited early impact. Am J Manag Care. 2015;21(7):511-7
34. Medina GG, McQueen A, Greisinger AJ, Bartholomew LK, Vernon SW. What would make getting colorectal cancer screening easier? Perspectives from screeners and nonscreeners. Gastroenterology Research and Practice [serial on the Internet]. 2012 [cited 2017 Sep 27]. Available from: https://www .hindawi.com/journals/grp/2012/ 895807/
35. Meissner HI, Klabunde CN, Breen N, Zapka JM. Breast and colorectal cancer screening: U.S. primary care physicians' reports of barriers. Am J Prev Med. 2012;43(6):584-9
36. Mehta SJ, Jensen CD, Quinn VP, Schottinger JE, Zauber AG, Meester R, et al. Race/ethnicity and adoption of a population health management approach to colorectal cancer screening in a community-based healthcare system. J Gen Intern Med. 2016;31(11):1323-30
37. Subramanian S, Bobashev G, Morris RJ.When budgets are tight, there are better options than colonoscopies for colorectal cancer screening. Health Aff (Millwood). 2010;29(9): 1734-40
38. Doubeni CA, Corley DA, Zauber AG. Colorectal cancer health disparities and the role of US law and health policy. Gastroenterology. 2016; 150(5):1052-5
39. Henry J. Kaiser Family Foundation. Status of state action on the Medicaid expansion decision [Internet]. Menlo Park (CA): KFF; 2017 Jan 1 [cited 2017 Sep 27]. Available from: http://www.kff.org/health-reform/ state-indicator/state-activityaround-expanding-medicaid-underthe-affordable-care-act
40. Schoen C, Osborn R, Squires D, Doty MM. Access, affordability, and insurance complexity are often worse in the United States compared to ten other countries. Health Aff (Millwood). 2013;32(12):2205-15
41. HealthyPeople.gov. Disparities [Internet]. Washington (DC): Department of Health and Human Services; [last updated 2017 Sep 26; cited 2017 Sep 27]. Available from: https:// www.healthypeople.gov/2020/ about/foundation-health-measures/ Disparities