In February 2015, the Centers for Medicare & Medicaid Services (CMS) issued a final national coverage determination that provides for Medicare coverage of screening for lung cancer with low-dose computed tomography (LDCT).
“This is the first time that Medicare has covered lung cancer screening. This is an important new Medicare preventive benefit, since lung cancer is the third most common cancer and the leading cause of cancer death in the United States,” said Patrick Conway, MD, chief medical officer and deputy administrator for innovation and quality at the CMS, in a press statement.
“Today, Medicare announced action that will save lives and increase the low survival rates associated with lung cancer, our nation’s leading cancer killer,” said Harold P. Wimmer, national president and CEO of the American Lung Association, in a press statement.
Lung cancer is the leading cause of cancer deaths in the country, making screening and possible early intervention even more critical. Approximately 4 million Medicare beneficiaries meet the eligibility criteria for screening, according to the nonprofit Lung Cancer Alliance.
The screening will be covered once a year for high-risk patients age 55-77. To qualify, Medicare beneficiaries must:
- currently smoke tobacco products or have quit within the past 15 years,
- have smoked an average of one pack of cigarettes a day for 30 years, and
- have a physician or other health care professional’s written order requesting the test.
The new coverage includes patient counseling and education about tobacco use and the potential harms and benefits of lung cancer screening. Informed decision-making is important for high-risk patients and their families. Patients should make a decision regarding screening, and their over-all health, after being informed about benefits, limitations, and harms associated with cancer screening. Healthcare professionals understand and appreciate the power of knowledge for their patients. The provider’s time with an educated patient is often more productive and effective.
Our evidence-based Lung Cancer Risk Profiler provides screening recommendations based on these current guidelines. The calculation takes into consideration pack-years smoked and the consumers’ lifestyle, genetics, and personal health histories and aids in the patient’s discussion with their physician.The profiler contains pertinent questions used to calculate consumers’ health risks and assess their symptoms. A personalized summary report of risk factors, tips to reduce risks, and actionable next steps is available to consumers who provide their contact information.
By identifying at-risk consumers, hospitals can connect them to their service providers to improve population health, enhance patient experience and outcomes, and extend community outreach.