New Preventive Screening Benefit

Health Tradition covers Mayo Clinic-developed Cologuard® colorectal cancer screening

A Mayo Clinic team led by gastroenterologist David Ahlquist, M.D. has developed a new test predicted to change the landscape of colorectal cancer (CRC) screening. The test was added to insurance coverage provided by Health Tradition Health Plan in 2016.

What is Cologuard?

Cologuard® is a highly accurate, noninvasive DNA screening test recently approved by both the Food and Drug Administration (FDA) and Centers for Medicare and Medicaid Services (CMS). A simultaneous approval process by both agencies is extremely rare. They were conducted together to expedite the introduction due to Cologuard’s important preventive care implications. Medicare has approved reimbursement for the test.

Patients are more likely to get screened

The new test is not intended to replace diagnostic colonoscopy, but has the potential to lower colorectal screening costs and increase the liklihood of patients being screened. John B. Kisiel, M.D., a gastroenterologist at Mayo’s Rochester campus who was actively involved in Cologuard research, explains. “Although colorectal cancer is almost entirely preventable, it is the second-leading cause of cancer mortality in adults in the United States, mainly because 1 in 3 people who are eligible for screening don’t participate.”

More convenient

Colonoscopy, the most widely used screening method, is more expensive and requires bowel prep and sedation. It also requires time off work, both for patients and a friend or family member to drive them home, and people are simply reluctant to undergo it. We tried to eliminate as many of those barriers as possible,” according to Dr. Kisiel. With Cologuard, a sample is taken by the patient at home, then sent to the laboratory.

Health Tradition covers Cologuard

Martha Binn, M.D., medical director of Health Tradition Health Plan, also sees the potential of Cologuard. “We are continually looking for ways to encourage preventive screening. The relatively low cost of Cologuard, the potential for greater participation—and especially the prospect of catching cancers earlier—are all exciting. The fact that this advance came from Mayo Clinic research adds yet another dimension. Health Tradition members directly benefit from Mayo Clinic expertise.”

Cologuard is only for those at low risk for colon cancer. Providers will determine which colorectal screening methods are appropriate for individual patients.

More about Cologuard