A national colorectal cancer awareness group has recognized Cambia Health Solutions for its leadership in preventing colorectal cancer
Preventing Colorectal Cancer, an Annapolis, Md.-based group of physicians and advocates, awarded Cambia's medical director Dr. Csaba Mera last week with its Champion Award. This award was created to recognize groups that either provide excellent care or advocacy relating to the disease.
Executive director Randall Madry said Cambia is the first insurer Preventing Colorectal Cancer has recognized since the award was created in 2011. Access to colonoscopies is “still an issue in so many places,” with patients sometimes being afraid to get colonoscopies because they think doctors will find polyps and charge them more money.
Billing polyp removal as a “diagnostic charge” was relatively common until recently, despite provisions in the Affordable Care Act prohibiting such surcharges. An overlying Oregon law, introduced this year by Rep. Elizabeth Steiner Hayward (D-Portland), makes it clear to providers and insurers that the cost of colonoscopies must be covered in full.
Mera said when he became Cambia's medical director three and a half years ago, it was important to him to make sure the company covered colonoscopies in full. Cambia's actuaries told him covering the procedure was likely to increase the number of people seeking such a procedure, but Mera countered that, in this case, that's a good thing.
“We're doing this because it's the right thing to do. We want to be good stewards of the health of our members,” Mera said.
Steiner Hayward, who attended the press conference where the award was announced, made mention of House Bill 4085, saying the bill was necessary because “not all insurers are like Cambia.”
Regence BlueCross BlueShield, which is under Cambia's umbrella, was named in a Kaiser Health News report discussing insurers that had refused to fully cover the procedure. A spokesperson for the company later described that practice as a mistake, and said Regence would cover colonoscopies in the future.
“I'm now in an age group that friends talk about medical care,” said Dr. Ron Hapke, a gastroenterologist with Northwest Gastroenterology Clinic,, who's now at an age where friends are more likely to discuss their medical problems in social situations. Hapke said friends facing colonoscopies are less likely to ask him if he thinks polyps will be found, and more likely to ask if the procedure will hurt.
Mera described his own recent colonoscopy, saying it was completely painless, and he doesn't remember a second of it. In fact, he doesn't remember getting dressed that morning, being driven to the clinic or going out to lunch afterward.
According to the Centers for Disease Control and Prevention, the incidence of colorectal cancer decreased by 3.8 percent per year among men during the years between 2001 and 2010, and by 3.2 percent per year among women. Mortality rates for both men and women dropped by 3 percent per year, for both men and women.
That's largely due to increased access to colonoscopies, which are unique among cancer screening procedures because in the vast majority of cases, they can prevent the disease.
“The last thing anyone wants to hear is, 'You've got cancer,” Steiner Hayward said. “With this, you can hear, 'You had cancer and we cured it.' We can catch it early. We don't have that ability with breast cancer.”
Steiner Hayward was referring to the fact that Stage I colorectal cancer can be cured by removing polyps, with no further treatment being necessary.
Preventing Colorectal Cancer is a 501c6 not-for-profit advocacy organization with a primary mission of educating stakeholders about effective screening, prevention and care of colorectal cancer. Other recipients of this year's PCC Champion award include the Chris4Life Colon Cancer Foundation, the Greater Chattanooga Colon Cancer Foundation and to Minnesota-based gastroenterologist and researcher Dr. Aasma Shaukat.
Christen McCurdy can be reached at [email protected].
Image for this story by Christen McCurdy.
