Dr Maen Hussein Discusses Means to Reduce Lung Cancer Mortality

Educating primary care providers and patients on accessible lung cancer screenings can help reduce lung cancer mortality, said Maen Hussein, MD, physician director of finance at Florida Cancer Specialists.

Transcript:

In order to reduce lung cancer mortality, what should payers and others do to promote more lung cancer screening?

When the Veterans Affairs (VA) study came out and showed that CT scans, low dose CT scans, can help in reducing the mortality from lung cancer, this was a test that wasn't approved by Medicare. Medicare wasn't paying for it yet and insurance actually didn't pay for it. So we had a pilot program where I practice, in an area called The Villages, where we had a cancer committee and we decided to have our own initiative. We had some kind of program where the radiology department provided this for like $100, so it's not very expensive. A lot of people who smoke can afford $100. Then we arranged for a way where, if it is abnormal, we can have physicians, oncologists, surgeons, or pulmologists read the test and discuss it with the patient, have the patient visit and make recommendations for what the next step should be.

We advertised it in the newspaper and within a month we had around maybe 40 to 50 patients who came and had that test within a month. We found 4 cases of early stage lung cancer that we were able to cure, through either surgery or stereotactic radiosurgery. So that's around 10%, we saved around 10% of those patients. Then Medicare caught up and and started paying for it. Unfortunately, a lot of the primary care doctors are still not aware of it. And we see a lot of patients will come to us who could have been probably saved if those tests were done. I think the payer should encourage those tests, that should be one of those quality measures. If you don't do that test, that might impact your payment. Make that test easy to access, to be accessible, no co-payment with that test, encourage the patients to do it. It's really not a very expensive test anyway, and it does save lives.

So the payer should educate the primary care, and I think one of the ways to educate them is, again to incentivize them to order those tests. Again, a lot of the value-based care models now can do either cost sharing or they incentivize for performing better and that could be one of the measures they can use in the targeted population. If you order that CAT scan then it's just like lowering cholesterol levels or controlling blood sugar or high blood pressure, because all these things prevent cardiac disease or are preventing lung cancer. It's even more important. I'm not saying lung cancer is more important than cardiac disease, but it is also a killer, it's the number one killer or reason for mortality from cancer. So we want to keep reducing that. I feel that they really should educate the primary care, educate the members of their insurance. We have insurance, we get letters from our insurance provider about you know, patients do their exercises, eat healthy, they encourage you because they don't want you to get sick because that would cost them more. So it's the same thing. If the patient is a smoker, educate them about the CAT scan, go ask your doctor about this CAT scan. That's a direct way to educate the physician. Those are ways and means for insurance companies and payers to encourage ordering those tests and then saving lives.