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U.S. Preventive Services Task Force Update and Computed Tomography for Colorectal Cancer Screening Among Privately Insured Population

  • Steven Chen
    Affiliations
    Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia

    Alliance of Community Health Plans, Washington, District of Columbia
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  • Courtney C. Moreno
    Affiliations
    Department of Radiology and Imaging Sciences, School of Medicine, Emory University, Atlanta, Georgia
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  • Richard Duszak Jr
    Affiliations
    Department of Radiology and Imaging Sciences, School of Medicine, Emory University, Atlanta, Georgia
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  • Michal Horný
    Correspondence
    Address correspondence to: Michal Horný, PhD, MSc, Department of Radiology and Imaging Sciences, Emory University School of Medicine, 101 Woodruff Circle, Woodruff Memorial Research Building, Room 1215A, Atlanta GA 30322.
    Affiliations
    Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia

    Department of Radiology and Imaging Sciences, School of Medicine, Emory University, Atlanta, Georgia
    Search for articles by this author

      Introduction

      The Affordable Care Act of 2010 mandated private health plans to fully cover the services recommended by the U.S. Preventive Services Task Force. In June 2016, the Task Force added computed tomography colonography to its list of recommended tests for colorectal cancer screening. This study evaluates the association among the updated recommendation, patient cost-sharing obligations, and the uptake of colorectal cancer screening through computed tomography colonography in the privately insured population.

      Methods

      Using individual claims from the 2010–2018 IBM MarketScan Commercial Database, monthly screening computed tomography colonography utilization rates per 100,000 privately insured beneficiaries aged 50–64 years and the monthly proportions of these services delivered by in-network providers for which patients had to bear a portion of the procedure costs were calculated, and an interrupted time series analysis was performed. The study was conducted between January and May 2020.

      Results

      Although the proportion of in-network procedures subject to patient cost sharing declined from 38.2% in 2010 to 10.2% in early 2016, the monthly utilization remained nearly constant. The announcement of the updated recommendation was associated with an immediate increase in the monthly screening computed tomography colonography utilization rate from 0.4 to 0.6 procedures per 100,000 individuals but with no change in the proportion of in-network procedures subject to patient cost sharing.

      Conclusions

      In an environment of already largely eliminated patient cost sharing, the release of supportive evidence-based recommendations by a recognized credible body was associated with an immediate increase in computed tomography colonography use for colorectal cancer screening in the privately insured population.
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