Highmark is expanding a low-cost approach to colon cancer screening that could help increase early detection while also avoiding the discomfort of invasive scoping and high treatment costs.
The Pittsburgh-based Blue Cross insurer of 5.2 million members in Pennsylvania, West Virginia and Delaware is offering seniors in its Medicare Advantage plans free fecal immunochemical test (FIT) kits for self-administered at-home screening.
The FIT kits detect blood in a person's stool, which can suggest the presence of a malignancy that can be investigated by a colonoscopy or lower gastrointestinal probe. The tests are about 80 percent accurate for indicating colon cancer.
Though not a wholesale replacement for colonoscopies, the "gold standard for colon cancer prevention, non-invasive biochemical tests like FIT kits can be a good option for people reluctant to undergo the full colonoscopy probe.
It's estimated that only about half of Americans 50 and older are actually getting the recommended colonoscopy, which can detect and also remove precancerous lesions. "By receiving routine health exams, like the FIT screening, seniors can stay healthier and avoid or delay the onset of illness down the road," said Donald Fischer, MD, Highmark's senior vice president and chief medical officer.
Highmark is offering the FIT kits to Medicare Advantage members through primary care doctors and its House Call Program, which brings members free at-home health assessment visits from an advanced practice nurse, using the contractor Matrix Medical Network.
The FIT is effective at finding blood in the stool, but members should "still have a colonoscopy every ten years because it finds such health issues as ulcers, colon polyps, tumors and areas of inflammation or bleeding," noted Fischer.
At the same time, given that a significant percentage of Americans are reluctant to undergo a colonoscopy, Highmark sees value in giving members the choice of the FIT screening. In one Kaiser Permanente study, colon cancer screenings increased by 40 percent when immunochemical tests were mailed to patients' homes.
Last year, some 4,700 Highmark members completed FIT screenings. In a survey, the insurer found that members in the House Call Program who took a FIT screening and received a "high alert" warning in the results were highly likely to consult a primary care doctor; 51 percent ended up getting a colonoscopy and 21 percent ended up being diagnosed with colon cancer or another condition.
Highmark, which is also the owner of a health system in greater Pittsburgh, is watching to see if the FIT screening and House Call Program can make a dent in the quality and costs of GI healthcare for its 300,000-plus Medicare Advantage members.
The average colon cancer treatment cost for a Medicare Advantage patient is approximately $30,000, Fischer noted.
"Providing care during the earliest stages of an illness is not only less expensive, but the success rate of treatment during this time is also more significant," he said. "Although a newly diagnosed condition can be extremely challenging for our members, being able to identify the issue early on helps us to connect them with the care they need so they can achieve successful health outcomes."