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Study Examines Effects of Regulations That Eliminate Insurance Cost-Sharing for Colorectal Cancer Screening

JAMA Network Open has published a new study – “Comparison of Screening Colonoscopy Rates After Positive Noninvasive Testing for Colorectal Cancer in States With and Without Cost-Sharing”– examining the effects of policies in Oregon and Kentucky that eliminate insurance cost-sharing for colorectal cancer screening procedures.

Authored by Douglas Barthold, PhD; Kai Yeung, PharmD, PhD; David Lieberman, MD; and A. Mark Fendrick, MD, the article reveals that, the elimination of cost sharing for the entire colorectal cancer screening process increased screening uptake in Oregon, but not in Kentucky.  “The removal of out-of-pocket costs is an important step to enhance screening uptake,” said lead author Douglas Barthold, PhD, Research Assistant Professor in University of Washington’s Department of Pharmacy and Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, “but additional elements such as access to care, health literacy, and transportation also influence screening rates.”

Importantly, the study introduces key findings that will inform an active policy debate on whether these regulations will be extended to the Medicare program. The findings from Oregon include a substantial shift in initial screening modality from colonoscopies (more expensive) to non-invasive testing (less expensive), leading to a lower cost-per-patient screened.

“The main goal of colorectal cancer screening is to identify those people who could benefit from early detection,” said co-author A. Mark Fendrick, MD, Director of the Center for Value-Based Insurance Design at the University of Michigan. “These findings suggest that the removal of financial barriers for the entire colorectal cancer screening process will lead to improved patient centered outcomes, enhanced equity and lower healthcare expenditures.”