When a colonoscopy (or other insurance approved screening ) might not be free

From the January 2012 blog posting ,Place the frustration of cost uncertainty on health insurers
by Kevin Pho at KevinMD.com

As we enter 2012, many patients will be changing to new insurance plans.

And for a few, deductibles will be rising.

One thing that’s emphasized in the Affordable Care Act, however, is that preventive services would remain “free.”

However, consider this story of a man, who thought he wouldn’t have to pay for his screening colonoscopy, instead was charged over $1,000 for the procedure.

From USA Today,

Bill Dunphy thought his colonoscopy would be free.

His insurance company told him it would be covered 100 percent, with no copayment from him and no charge against his deductible. The nation’s 1-year-old health law requires most insurance plans to cover all costs for preventive care including colon cancer screening. So Dunphy had the procedure in April.

Then the bill arrived: $1,100.

The reason? During the procedure, polyps were found and rightfully removed. But in doing so, it changed the colonoscopy from a screening procedure to a diagnostic procedure, thus making it applicable to the patient’s deductible.

Such semantics are important, as insurance companies will seize them at every opportunity to pass on costs to both patients and hospitals….

Read the entire article by Kevin Pho

 

Related articles

• Preventive care: It’s free, except when it’s not (goerie.com)
• Preventive care: It’s free, except when it’s not (usatoday.com)
• Loophole in U.S. law means not all preventive care free (ctv.ca)
• Preventive care: It’s free, except when it’s not (sfgate.com)
• Preventive care: It’s free, except when it’s not (seattlepi.com)
• Preventive Care Is Free — Except For When It’s Not (huffingtonpost.com)
• Preventive Care: It’s Free, Except When It’s Not (maboulette.wordpress.com)
• Preventive care: It’s free, except when it’s not (mysanantonio.com)
• Preventive care: It’s free, except when it’s not (seattletimes.nwsource.com)
• Know What to Expect From Colonoscopy Prep (everydayhealth.com)

Dentists Could Screen 20 Million Americans For Chronic Physical Illnesses

 

From a December 2011 press release of New York University

An Opportunity to Identify Diabetes, Hypertension, and Other Chronic Diseases

Nearly 20 million Americans annually visit a dentist but not a general healthcare provider, according to an NYU study published today in the American Journal of Public Health.

The study, conducted by a nursing-dental research team at NYU, is the first of its kind to determine the proportion of Americans who are seen annually by a dentist but not by a general healthcare provider.

This finding suggests dentists can play a crucial role as health care practitioners in the front-line defense of identifying systemic disease which would otherwise go undetected in a significant portion of the population, say the researchers.

“For these and other individuals, dental professionals are in a key position to assess and detect oral signs and symptoms of systemic health disorders that may otherwise go unnoticed, and to refer patients for follow-up care,” said Dr. Shiela Strauss, an associate professor of nursing at the NYU College of Nursing and co-director of the statistics and data management core for NYU’s Colleges of Nursing and Dentistry.

During the course of a routine dental examination, dentists and dental hygienists, as trained healthcare providers, can take a patient’s health history, check blood pressure, and use direct clinical observation and X-rays to detect risk for systemic conditions, such as diabetes, hypertension, and heart disease. ……

Read the entire news article

Related articles

• Barbers: Cut, Shave, Lower Your Blood Pressure (jflahiff.wordpress.com)
• Dentists Could Screen 20 Million Americans For Chronic Physical Illnesses (medicalnewstoday.com)

• NYU study concludes that dentists could screen 20 million Americans for chronic physical illnesses (eurekalert.org)
• Dentists could screen 20 million Americans for chronic physical illnesses: study (medicalxpress.com)
• Dentists Could Fill Gap in Health Care (nlm.nih.gov)

Self-Affirmation May Break Down Resistance to Medical Screening

From the 21 December 2011 News article

People resist medical screening, or don’t call back for the results, because they don’t want to know they’re sick or at risk for a disease. But many illnesses, such as HIV/AIDS and cancer, have a far a better prognosis if they’re caught early. How can health care providers break down that resistance?

Have people think about what they value most, finds a new study by University of Florida psychologists Jennifer L. Howell and James A. Shepperd. “If you can get people to refocus their attention from a threat to their overall sense of wellbeing, they are less likely to avoid threatening information,” says Howell. Do that, and people are more likely to face a medical screening even if it means undertaking onerous treatment and even if the disease is uncontrollable. The findings will appear in Psychological Science, a journal published by the Association for Psychological Science.

The researchers undertook three studies, each with about 100 students of both sexes. In all three studies, they asked the participants to think of a trait they valued; they chose traits such as honesty, compassion, and friendliness. Participants then wrote either about how they demonstrated the trait (expressing self-affirmation) or a friend (not affirming themselves) demonstrated the trait….

Read the entire news article

Related articles

• Self-affirmation may break down resistance to medical screening (medicalxpress.com)
• Self-affirmation may break down resistance to medical screening (eurekalert.org)
• When Are You Too Old For Routine Screening Tests? (aarp.org)
• Breast cancer screening saves lives – but it causes harm, too (telegraph.co.uk)
• African American Communities Face Aids Crisis (socyberty.com)
• Symptom-Based Screening May Improve Detection Of HIV In High-Risk Men (medicalnewstoday.com)

Many with Terminal Cancer Still Getting Routine Screens

Advanced cancer patients should not be put through futile testing at end of life, experts say

Excerpts from a Health Day news item

TUESDAY, Oct. 12 (HealthDay News) — Many patients with incurable cancer are still being screened for common cancers, although these tests are unlikely to provide any benefit, researchers from Memorial Sloan-Kettering Cancer Center in New York City have found.

Specifically, many patients diagnosed with advanced lung, colorectal, pancreatic, gastroesophageal or breast cancer are still undergoing the ordeal of routine breast, prostate and colon cancer screening, said the researchers. Not only might these patients suffer from invasive procedures like colonoscopies near the end of life, the researchers said, but they face the unnecessary risk of additional tests, biopsies and psychological distress resulting from the detection of new malignancies.

“For patients living with advanced cancer, cancer screening should not be a routine procedure,” said lead researcher Dr. Camelia S. Sima, an assistant attending biostatistician.

[snip]

The report is published in the Oct. 13 issue of the Journal of the American Medical Association.
The article is freely available at http://jama.ama-assn.org/cgi/content/full/304/14/1584

[snip]

There needs to be greater awareness that cancer screening when one is near the end of life is unlikely to provide a benefit, Sima pointed out.

“Screening guidelines could be reassessed to address the appropriateness of screening for patients whose very limited life expectancy due to advanced cancer negates any potential benefit that may be derived,” Sima said.

Commenting on the study, Dr. Len Lichtenfeld, deputy chief medical officer at the American Cancer Society, said that “we can do a lot of good with screening, but we have to recognize that there comes a time when it’s simply not the right thing to do.”

Lichtenfeld suggested that patients should discuss the appropriateness of a screening test with their doctor. “Putting people at the end of life through screening is not appropriate for the person, and from a societal viewpoint, it’s not a good use of our limited resources,” he said.

“Why would this happen in the first place?” Lichtenfeld asked. “It flies in the face of compassion; it flies in the face of common sense.”