Comparison of Lung Cancer Screening Eligibility and Use between Commercial, Medicare, and Medicare Advantage Enrollees.

Autor:	Hughes DR; Director, Health Economics and Analytics Lab, School of Economics, Georgia Institute of Technology, Atlanta, Georgia; Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia; and College of Health Solutions, Arizona State University, Phoenix, Arizona. Electronic address: danny.hughes@econ.gatech.edu., Chen J; Department of Health Professions, James Madison University, Harrisonburg, Virginia., Wallace AE; School of Economics, Georgia Institute of Technology, Atlanta, Georgia., Rajendra S; School of Economics, Georgia Institute of Technology, Atlanta, Georgia., Santavicca S; OncoHealth, Atlanta, Georgia. Electronic address: https://twitter.com/Stefan.Marchello., Duszak R Jr; Chair, Department of Radiology, University of Mississippi Medical Center, Jackson, Mississippi; and Chair, Commission on Leadership and Practice Development, American College of Radiology. Electronic address: https://twitter.com/RichDuszak., Rula EY; Executive Director, Harvey L. Neiman Health Policy Institute, Reston, Virginia., Smith RA; Senior Vice President, Early Cancer Detection Science, American Cancer Society, Atlanta, Georgia.
Jazyk:	angličtina
Zdroj:	Journal of the American College of Radiology : JACR [J Am Coll Radiol] 2023 Apr; Vol. 20 (4), pp. 402-410.
DOI:	10.1016/j.jacr.2022.12.022
Abstrakt:	Objective: Lung cancer screening does not require patient cost-sharing for insured people in the U.S. Little is known about whether other factors associated with patient selection into different insurance plans affect screening rates. We examined screening rates for enrollees in commercial, Medicare Fee-for-Service (FFS), and Medicare Advantage plans. Methods: County-level smoking rates from the 2017 County Health Rankings were used to estimate the number of enrollees eligible for lung cancer screening in two large retrospective claims databases covering: a 5% national sample of Medicare FFS enrollees; and 100% sample of enrollees associated with large commercial and Medicare Advantage carriers. Screening rates were estimated using observed claims, stratified by payer, before aggregation into national estimates by payer and demographics. Chi-square tests were used to examine differences in screening rates between payers. Results: There were 1,077,142 enrollees estimated to be eligible for screening. The overall estimated screening rate for enrollees by payer was 1.75% for commercial plans, 3.37% for Medicare FFS, and 4.56% for Medicare Advantage plans. Screening rates were estimated to be lowest among females (1.55%-4.02%), those aged 75-77 years (0.63%-2.87%), those residing in rural areas (1.88%-3.56%), and those in the West (1.16%-3.65%). Among Medicare FFS enrollees, screening rates by race/ethnicity were non-Hispanic White (3.71%), non-Hispanic Black (2.17%) and Other (1.68%). Conclusions: Considerable variation exists in lung cancer screening between different payers and across patient characteristics. Efforts targeting historically vulnerable populations could present opportunities to increase screening. (Copyright © 2023 American College of Radiology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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