As Oncology Care Options Broaden, Providers Get Selective
Healthcare leaders are weighing evidence and making decisions on the value of adopting new cancer services, including low-dose CT scans, high-priced drugs, and efforts to address comorbidities.
This article first appeared in the March 2015 issue of HealthLeaders magazine.
Data began to emerge in the late 1990s that computed tomography scans could detect early-stage lung cancer, and patients started lobbying hospitals to offer the service. Lung cancer is difficult to catch early and is usually lethal.
But many hospitals are just now offering the service. Low-dose CT lung cancer screening looked promising 20 years ago, yet there were enough outstanding questions to keep most payers from covering it.
What has changed? In 2011, a long-term randomized clinical trial produced evidence of a 20% reduction in mortality for high-risk patients. In November 2014, the Centers for Medicare & Medicaid Services announced that it would begin paying for the scans. Once Medicare moves, private insurers usually follow.