A new study in Current Medical Research and Opinion found that eliminating patient cost sharing for follow-up colonoscopy after a positive stool-based test led to a 41.2% increase in utilization, with the effect sustained nationwide.
The change followed federal actions in January 2023 — tri-department guidance for ACA-compliant/private insurance and a CMS rule extending coverage to Medicare. Researchers analyzed data from 10.8 million colonoscopies (Jan 2022–Nov 2023) using an interrupted time series design, adjusting for seasonal trends.
- Before policy: follow-up colonoscopies = 3.59% of all procedures.
- After policy: immediate absolute increase of 1.48% (95% CI, 1.25–1.71).
- Impact: improved completion of colorectal cancer (CRC) screening pathways.
The study notes limitations, including reliance on claims data, short timeframe, and inability to isolate all contributing factors. Still, findings highlight how removing financial barriers supports equitable CRC screening, especially when costs for bowel prep and diagnostic follow-up historically deterred patients.