Implementation of Shared Decision Making for Lung Cancer Screening Among the Privately Insured Nonelderly

Introduction. The Centers for Medicare & Medicaid Services requires a written order of shared decision making (SDM) visit in its coverage policy for low-dose computed tomography (LDCT) for lung cancer screening (LCS). With screening eligibility starting at age 55, private insurance plans will li...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Ya-Chen Tina Shih, Ying Xu, Lisa M. Lowenstein, Robert J. Volk
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/63bc88075b4643e9a2d7ae4f81c11f98
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:63bc88075b4643e9a2d7ae4f81c11f98
record_format	dspace
spelling	oai:doaj.org-article:63bc88075b4643e9a2d7ae4f81c11f982021-11-11T14:33:21ZImplementation of Shared Decision Making for Lung Cancer Screening Among the Privately Insured Nonelderly2381-468310.1177/2381468320984773https://doaj.org/article/63bc88075b4643e9a2d7ae4f81c11f982021-01-01T00:00:00Zhttps://doi.org/10.1177/2381468320984773https://doaj.org/toc/2381-4683Introduction. The Centers for Medicare & Medicaid Services requires a written order of shared decision making (SDM) visit in its coverage policy for low-dose computed tomography (LDCT) for lung cancer screening (LCS). With screening eligibility starting at age 55, private insurance plans will likely adopt this coverage policy. This study examined the implementation of SDM in the context of LCS among the privately insured. Methods. We constructed two study cohorts from MarketScan Commercial Claims and Encounters database 2016-2017: a LDCT cohort who received LDCT for LCS and an SDM cohort who had an LCS-related SDM visit. For the LDCT cohort, we examined the trend and factors associated with the receipt of SDM within 3 months prior to LDCT. For the SDM cohort, we studied the trend and factors associated with LDCT within 3 months after an SDM visit. Results. For privately insured adults aged <64, 93% (19,681/21,084) of the LDCT cohort did not have a billing claim indicating SDM, although the uptake of SDM increased from 3.1% in 1Q2016 to 8.2% in 4Q2017 ( P < 0.0001). For the SDM cohort, 46% (948/2048) did not have a claim for an LDCT for lung cancer screening in the 3 months after the SDM visit; this percentage increased from 29.5% in 1Q2016 to 61.8% in 3Q2017 ( P < 0.0001). Limitations. Findings cannot be generalized to other nonelderly adults without private insurance. Additionally, the rate of SDM identified from claims may be underreported. Conclusions. We found a growing but low uptake of SDM among privately insured individuals who underwent LDCT. The higher rate of LDCT in the SDM cohort than the rate reported in national studies emphasized the importance of patient awareness.Ya-Chen Tina ShihYing XuLisa M. LowensteinRobert J. VolkSAGE PublishingarticleMedicine (General)R5-920ENMDM Policy & Practice, Vol 6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Ya-Chen Tina Shih Ying Xu Lisa M. Lowenstein Robert J. Volk Implementation of Shared Decision Making for Lung Cancer Screening Among the Privately Insured Nonelderly
description	Introduction. The Centers for Medicare & Medicaid Services requires a written order of shared decision making (SDM) visit in its coverage policy for low-dose computed tomography (LDCT) for lung cancer screening (LCS). With screening eligibility starting at age 55, private insurance plans will likely adopt this coverage policy. This study examined the implementation of SDM in the context of LCS among the privately insured. Methods. We constructed two study cohorts from MarketScan Commercial Claims and Encounters database 2016-2017: a LDCT cohort who received LDCT for LCS and an SDM cohort who had an LCS-related SDM visit. For the LDCT cohort, we examined the trend and factors associated with the receipt of SDM within 3 months prior to LDCT. For the SDM cohort, we studied the trend and factors associated with LDCT within 3 months after an SDM visit. Results. For privately insured adults aged <64, 93% (19,681/21,084) of the LDCT cohort did not have a billing claim indicating SDM, although the uptake of SDM increased from 3.1% in 1Q2016 to 8.2% in 4Q2017 ( P < 0.0001). For the SDM cohort, 46% (948/2048) did not have a claim for an LDCT for lung cancer screening in the 3 months after the SDM visit; this percentage increased from 29.5% in 1Q2016 to 61.8% in 3Q2017 ( P < 0.0001). Limitations. Findings cannot be generalized to other nonelderly adults without private insurance. Additionally, the rate of SDM identified from claims may be underreported. Conclusions. We found a growing but low uptake of SDM among privately insured individuals who underwent LDCT. The higher rate of LDCT in the SDM cohort than the rate reported in national studies emphasized the importance of patient awareness.
format	article
author	Ya-Chen Tina Shih Ying Xu Lisa M. Lowenstein Robert J. Volk
author_facet	Ya-Chen Tina Shih Ying Xu Lisa M. Lowenstein Robert J. Volk
author_sort	Ya-Chen Tina Shih
title	Implementation of Shared Decision Making for Lung Cancer Screening Among the Privately Insured Nonelderly
title_short	Implementation of Shared Decision Making for Lung Cancer Screening Among the Privately Insured Nonelderly
title_full	Implementation of Shared Decision Making for Lung Cancer Screening Among the Privately Insured Nonelderly
title_fullStr	Implementation of Shared Decision Making for Lung Cancer Screening Among the Privately Insured Nonelderly
title_full_unstemmed	Implementation of Shared Decision Making for Lung Cancer Screening Among the Privately Insured Nonelderly
title_sort	implementation of shared decision making for lung cancer screening among the privately insured nonelderly
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/63bc88075b4643e9a2d7ae4f81c11f98
work_keys_str_mv	AT yachentinashih implementationofshareddecisionmakingforlungcancerscreeningamongtheprivatelyinsurednonelderly AT yingxu implementationofshareddecisionmakingforlungcancerscreeningamongtheprivatelyinsurednonelderly AT lisamlowenstein implementationofshareddecisionmakingforlungcancerscreeningamongtheprivatelyinsurednonelderly AT robertjvolk implementationofshareddecisionmakingforlungcancerscreeningamongtheprivatelyinsurednonelderly
_version_	1718438940507111424

Implementation of Shared Decision Making for Lung Cancer Screening Among the Privately Insured Nonelderly

Ejemplares similares