What kind of colorectal cancer screening is best? Which is most cost-effective? And what do I need to cover in my benefit plan?

The Alliance recently created an employer briefing to help employers answer these questions about colorectal cancer screening.

The briefing reflects the 2016 recommendations on colorectal cancer screening from the U.S. Preventive Services Task Force (USPSTF). The chart below is part of the employer briefing; we’re sharing it here to give you a quick comparison of colorectal cancer screening options.

So which type of colorectal cancer screening is best? The USPSTF and other experts say it’s the one that employees will actually use. I encourage you to check out the employer briefing to learn more about covering colorectal cancer screening in your self-funded health plan.

Comparing Colorectal Cancer Screening Options in The Alliance Network

Test Interval Per Screening Procedure Cost to Employer*+ Total Estimated Screening Cost,
Age 50 – 75#
Colonoscopy Every 10 years $2,300 – $5,100 Medium Anticipated Cost
FIT Every year $130 – $530! Low Anticipated Cost
FOBT Every year $40 – $410! Low Anticipated Cost
Sigmoidoscopy Every 10 years plus FIT every year $1580 – $1620 High Anticipated Cost
CT Colonography Every 5 years $1,330 Low Anticipated Cost
Fecal DNA Testing Every 3 years $550 Low Anticipated Cost

*Screening should require $0 patient out-of-pocket costs but the amount your employer is charged by the hospital will vary based on type of test and location of service. Your employer pays for your health care benefits directly rather than paying for insurance.
+Cost Per Screening encompasses a median of all typical charges rendered the same day as the screening.
!The costs of the individual services for FIT and FOBT tests are typically very small ($15 – $50); however, it is typical this test is done in conjunction with other services done the same day. We show the estimated cost range based on provider billing and service practices for the entire day of service.
#Modeled results of total estimated screening cost full methodology available here.

Test CPT Codes Used for Screening
Colonoscopy 45378
FIT 82274
FOBT 82770
Sigmoidoscopy 45330
CT Colonography 74261-74263
Fecal DNA Test 81528

Read the briefing

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Amy Moyer

Amy Moyer

Manager of Value Measurement at The Alliance
Amy Moyer joined The Alliance in 2011 as manager of value measurement. In her role, she manages and executes cost and quality measurement and reporting strategies for The Alliance and its members. She's played a critical role in developing The Alliance's QualityPath® initiative. She also participates in state and federal measurement initiatives.

Prior to joining The Alliance, Amy served as the quality program administrator at Physicians Plus Insurance Corporation. She took on the role of project manager for the National Committee for Quality Assurance (NCQA) accreditation efforts as well as the development and reporting of key health plan quality metrics. Her resume also includes work at UW Health (University of Wisconsin Hospital and Clinics) where she served as a clinical content facilitator.

Amy attended University of Wisconsin-Platteville where she received her Master of Science in project management and Lawrence University where she received her Bachelor of Arts degree in music, neuroscience and biomedical ethics.

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Amy Moyer

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