Eliminating cost-sharing requirements for colon cancer screening in Medicare

• Type of Material: Article
• Authors: David Howard, Emory University; Gery P. Guy, Jr, Centers for Disease Control and Prevention; Donatus U. Ekwueme, Centers for Disease Control and Prevention
• Language: English
• Date: 2014-12-15
• Publisher: Wiley
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 American Cancer Society. This article has been contributed to by US Government employees and their work is in the public domain in the USA.
• Final Published Version (URL): http://dx.doi.org/10.1002/cncr.29093
• Title of Journal or Parent Work: Cancer
• ISSN: 0008-543X
• Volume: 120
• Issue: 24
• Start Page: 3850
• End Page: 3852
• Grant/Funding Information: David H. Howard received support for this research from the Centers for Disease Control and Prevention (12IPA1203126).
• Keywords: health reform; health insurance; cancer screening; Medicare; colorectal cancer
• Research Categories: Health Sciences, Oncology; Health Sciences, General; Health Sciences, Health Care Management

Abstract

Medicare beneficiaries do not have to pay for screening colonoscopies but must pay coinsurance if a polyp is removed via polypectomy. Likewise, beneficiaries do not have to pay for fecal occult blood tests but are liable for cost-sharing for diagnostic colonoscopies after a positive test. Legislative and regulatory requirements related to colorectal cancer screening are described, and on the basis of Medicare claims, it is estimated that Medicare spending would increase by $48 million annually if Medicare were to waive cost-sharing requirements for these services. The economic impact on Medicare if beneficiaries were not responsible for any cost-sharing requirements related to colorectal cancer screening services is described.