Lack of Medicare coverage for CT colonography dragging down screenings, with Black patients hit harder
A lack of Medicare coverage for CT colonography imaging is dragging down use in the older population, and likely hitting black patients harder, according to an analysis published Sunday.
The Affordable Care Act mandated that commercial payers cover such CTC exams. However, the federal payment program for seniors has failed to do the same. Wanting to better understand how this impacts use, a team of experts analyzed data representing a 13-year period ending in 2020.
Bottom line: Between the ages of 52 and 64, the number of CTC exams increased by 5.3%. But the number of screenings plummeted by an average of 6.9% per year of age after 65, researchers reported Oct. 18 in JACR.
“The association between the use of CTC and Medicare-eligible age varied for white individuals as compared with Black individuals and other racial minorities, suggesting that the lack of Medicare coverage may be more negatively impacting racial minorities,” concluded Emory University’s Courtney Moreno, MD, chair of the American College of Radiology’s CT Colonography Registry Committee, and colleagues. “Medicare coverage of screening CTC is needed so that Medicare patients who cannot afford to pay for this test out of pocket can undergo screening CTC.”
Colorectal cancer is the second leading cancer-related cause of death in the U.S.—killing 53,000 individuals annually—and it’s preventable with proper screening. Yet only 61% of those ages 50-64 report being up to date on their exams, versus 71% in the 65-and-up population, the authors noted.
To conduct their study, Moreno et al. used data from the ACR’s CTC registry, representing 12,648 screening exams. They noted that the majority of patients undergoing such imaging were female (62%) and white (at 91% of the 8,682 who disclosed their race). The average cost of a CTC scan not covered by health insurance lands at about $2,400, the team noted, and can range as high as $5,000, underlining the importance of Medicare payment. Further investigations are needed to better understand Black patients’ obstacles to regular screenings.
“The goal of cancer screening is for as many people to be screened as possible, and the best way to accomplish this is to reduce barriers to all methods of colorectal cancer screening including CTC,” the team wrote.
Read much more in the Journal of the American College of Radiology here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.