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What Employers Need to Know About Preventive vs. Diagnostic Cancer Screenings

Research shows that people on high-deductible health plans tend to delay diagnostic cancer screenings. When time is of the essence, empowering people to pay for their care is crucial.

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When it comes to breast cancer, early diagnosis is a major contributor to successful treatment. But in some cases, an inability to pay for important diagnostic screenings can prevent people from receiving medical attention in a timely fashion.

A recent study published in the Journal of Clinical Oncology found that people on high-deductible health plans tend to be diagnosed with metastatic breast cancer an average of 4.6 months later than folks with low-deductible health insurance. That’s because patients on high-deductible health plans must pay the full cost of their care until they’ve met those deductibles.

At this point, more than half of U.S. workers are covered by high-deductible health plans. Higher out-of-pocket healthcare costs — coupled with financial stress due to inflation — are causing many folks to delay a visit to the doctor when symptoms of concern arise.

That’s particularly troubling in the case of breast cancer, where early detection is an important factor in successful treatment. A study published in the British Medical Journal found that every month of delayed cancer treatment leads to a 10% increase in the risk of death. There are consequences of delaying medical care, and those consequences are only more severe when we’re talking about cancer treatment.

Encouraging Early Breast Cancer Detection

According to the National Cancer Institute, breast cancer is one of the most common forms of cancer in the U.S. Cancer screenings for breast, ovarian, and cervical cancers are typically covered by insurance during annual well-woman exams because they’re considered preventative screenings.

But when a person discovers a lump or experiences irritation and dimpling of the breast skin, the doctor’s visit that follows is considered a diagnostic cancer screening. Under most high-deductible plans, the patient is responsible for all out-of-pocket costs until they’ve met their deductible. According to the Brem Foundation, diagnostic mammograms cost about $290 on average. Considering many people say they cannot afford to cover a $400 emergency, this is not an insignificant sum.

Meanwhile, benign breast disease — which can manifest as anything from a lump to breast pain to an inverted, creased, or scaly nipple — is a common condition. According to the Cleveland Clinic, up to half of all women will experience fluctuating hormone levels that lead to breast tissue changes or a benign breast lump at some point in their lives.

While it’s welcome news that most breast lumps are benign, the only way to verify whether you have a benign breast lump is to undergo a mammogram, ultrasound, core biopsy, or fine-needle aspiration to test the cells. Often, it’s necessary to do a follow-up appointment and undergo regular imaging.

Since these important tests are not considered preventive care, that means many high-deductible health plans do not cover them. The costs associated with follow-up care can be a daunting prospect for many people.

How to Make Paying for Care Make Sense

There’s still a lot to be said for high-deductible vs. low-deductible health plans — namely lower insurance premiums, which equate to more affordable monthly fees. Most young and relatively healthy workers can get a lot of traction out of a high-deductible health plan without any of the trade-offs.

Still, it’s important to provide a safety net for employees who might experience a healthcare emergency like a cancer scare. An employee benefit like Paytient, which provides an interest-free line of credit to cover out-of-pocket healthcare costs, can go a long way toward making folks feel comfortable with their liquidity.

With a Paytient card, medical appointments that might have seemed like a gamble — “It costs $299 to see a doctor. What if my symptoms turn out to be nothing?” — can effortlessly be paid off in manageable increments.

When people feel empowered to cover the out-of-pocket costs of cancer screenings and treatments, they are more apt to take charge of their health. This sort of early care is absolutely crucial in improving health outcomes while decreasing overall healthcare costs.

Healthcare Equity
Employee Wellness
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