Arkansas Patients Often Face Financial Barriers to Necessary Follow-Up Colonoscopies

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Fight Colorectal Cancer and the Arkansas Center for Health Improvement Use Data To Advance Policy Change in Arkansas and Beyond

National nonprofit Fight Colorectal Cancer (Fight CRC) and health policy experts at the Arkansas Center for Health Improvement (ACHI) have developed a report assessing the prevalence of colorectal cancer screening in Arkansas and identifying gaps in access to screening. They plan to use the findings to advance policy change to help increase access to life-saving colorectal cancer screening in Arkansas and across the country. 

With timely screening, colorectal cancer can be prevented or detected early ― when it’s most curable. Unfortunately, one in three people are not up to date on colorectal cancer screening. For patients at average risk, there are multiple options for colorectal cancer screening, including less invasive tests such as the fecal immunochemical test, or FIT, and Cologuard. These can be great tools to help increase screening rates. 

However, if a patient receives a positive result on a non-invasive test, they must get a colonoscopy to complete screening. Unfortunately, the report found that among Arkansas patients ages 50 to 75 enrolled in Medicare, commercial insurance, traditional Medicaid or Arkansas Works, three out of five face financial barriers to accessing that necessary colonoscopy. Using the data report developed by Fight CRC and ACHI, states across the country will be able to leverage data to inform policy change to help remove barriers to colorectal cancer screening.

The report draws on data from the Arkansas All-Payer Claims Database, a part of the Arkansas Healthcare Transparency Initiative. The initiative was created under a 2015 legislative act to bring increased transparency to healthcare utilization, quality and price information in Arkansas. Twenty-one states have created or are implementing all-payer claims databases.

“Data is an incredibly powerful advocacy tool,” said Molly McDonnell, Fight CRC’s advocacy director. “Fight CRC is thrilled to partner with ACHI on this report that will help empower advocates across the country to leverage their state data and build a case for policy change to help remove barriers to colorectal cancer screening.” 

Craig Wilson, J.D., M.P.A., the director of health policy at ACHI, presented the report at Fight CRC’s State-by-State Catalyst Meeting in Springfield, Mo., on Dec. 2. Wilson highlighted the importance of sharing data alongside advocate stories to make legislative change. 

“At the core of this report we looked at access issues for colorectal cancer screening in Arkansas, but it is now a blueprint for other states to use on their own populations,” said Wilson. “Our hope is that this blueprint will be shared and used to make real policy change in states across the country.” 

The Arkansas General Assembly and Gov. Asa Hutchinson have recognized the importance of improving access to colorectal cancer screening. On April 21, Hutchinson signed into law Act 779 of 2021, which will lower the age range for covered colorectal cancer preventive screenings from 50 and above to 45 and above, effective Jan. 1, 2022. The new law will also prohibit cost-sharing for a follow-up colonoscopy — a colonoscopy performed after a positive or abnormal result from a non-colonoscopy colorectal cancer screening test, such as a fecal immunochemical test, Cologuard, or a high-sensitivity guaiac fecal occult blood test. The law will apply to most individual and group insurance policies, including those covering Medicaid expansion beneficiaries through the Arkansas Works program and the state and public school employee health benefit plan. This law has also been passed in several other states across the country including Texas, Rhode Island, California, Oregon, Kentucky, Maine, and Illinois. 

Learn more about Fight CRC’s advocacy efforts by visiting FightCRC.org/advocacy, and learn more about ACHI’s health priorities at ACHI.net

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