The Evolution and Promise of Preventive Screenings at Home

The number of patients under age 50 diagnosed with colorectal cancer (CRC) is rising. In 2020, 17,930 (12%) of the 147,950 individuals newly diagnosed with CRC in the United States were younger than 50 year.

For this and other reasons, the American Cancer Society now recommends starting CRC screening at age 45. Yet many health plans — mine included — still do not cover screenings for colorectal cancer until 50.

Mounting evidence suggests that the decision among payers to cover diagnostic/screening services is primarily math-based. On one side of the equation, it’s understandable. The business case for paying up to $1,150 per person to screen individuals in their 40s in medical settings does not exist.

Unfortunately, paying out of pocket is often a nonstarter for most people: A recent Federal Reserve survey found that 40% of American adults lack available cash to cover a $400 emergency. What’s worse is that many lifestyle contributors to colorectal cancer, diabetes and other chronic diseases — like alcohol use, smoking and obesity — are also associated with poverty.

Cancer is only one example, but there are others that highlight the health insurance industry’s sometimes conservative approach to preventive care — an approach that isn’t always in alignment with guidelines set by groups such as the American Cancer Society and the American Diabetes Association.

Preventive care: A balancing act

This puts the health industry, including payers, in a tricky position: Health plans recognize the benefit of preventive care and want to expand coverage. Yet the financial barriers to doing so are significant. In-person screenings are not cheap to administer for payers or employers, who are seeking new ways to cut benefit costs to offset financial losses of 2020.

There are also nonfinancial barriers to screening for patients. Many Americans don’t have the time or resources to take leave from work to focus on preventive care. This became especially clear during the first six to nine months of the COVID-19 pandemic, when a significant number of individuals avoided seeing a doctor out of fear of contracting the coronavirus even as their physical pain or discomfort increased.

The good news, for employers and health plans, is that a better option is emerging. Today, screening technology has advanced considerably, and there is an opportunity to nudge the needle on preventable chronic diseases, which account for the bulk of healthcare expenses.

In 2021, we’re seeing the expansion of state-of-the-art home testing kits that can gauge risk for multiple conditions, including diabetes, hypertension and multiple cancers. The best part: Screening tools are designed to be used in the comfort of a person’s home.

The convenience factor

Tests that allow individuals to collect biometric samples in the privacy of their own homes — and enable individuals to measure cholesterol, blood pressure, and blood-glucose levels, for example — have the potential to make a marked difference in many areas. What’s more, they can offer healthcare providers critical insights into major health changes, much in the same way that advances in home pregnancy tests enabled OB/GYNs to shift much of their focus to prenatal care decades ago.

Some of the benefits include:

Convenience. Consumers are more likely to undergo routine screening when the act of testing is hassle free – especially if they’re young and healthy.

Safety. In the event of a widespread viral outbreak, such as COVID-19 or measles, home-based testing makes it possible to stay home.

Cost savings.The cost to administer home testing kits can range from $25 to $200 per person (depending on how comprehensive the kit is), far less expensive than medical facility screening.

Healthcare outcomes. The sooner an individual is aware of a burgeoning health problem, the faster he or she can seek treatment, and improve long-term outcomes.

Satisfaction. When employers and health plans demonstrate a vested interest in an individual’s wellbeing, satisfaction and engagement rises. Businesses with highly engaged business units saw 41% reduction in absenteeism, per one 2019 Gallup study.

As organizations begin reopening offices and adapting work environments and benefits to post-pandemic norms, these are important benefits to consider. The more vested employers and health plans are in keeping everyone healthy before an emergency, the better off they’ll be financially — and the better off patients will be in terms of wellness.

The use of home-based testing solutions can disrupt the negative cycle of pricey screenings, delayed healthcare, and poor outcomes. With the right tools and information at our disposal, it’s possible for managed healthcare organizations, physicians, and nonphysician providers to work cohesively to narrow the care gaps of 2020, and help more Americans stay healthy, whether they choose to venture out or stay home.

Travis Rush is the CEO and co-founder of Reperio Health, a company that develops and markets home-based testing.