Lowenstein Lisa M, Nishi Shawn P E, Lopez-Olivo Maria A, Crocker Laura Covarrubias, Choi Noah, Kim Bumyang, Shih Ya-Chen Tina, Volk Robert J
Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Division of Pulmonary and Critical Care Medicine, The University of Texas Medical Branch, Galveston, Texas.
Cancer. 2022 May 15;128(10):1967-1975. doi: 10.1002/cncr.34145. Epub 2022 Feb 14.
Little is known about how screening facilities are meeting the requirements for the reimbursement of lung cancer screening from the Centers for Medicare & Medicaid Services (CMS), including 1) the collection and submission of data to the CMS-approved registry (American College of Radiology [ACR] Lung Cancer Screening Registry), 2) the verification of a counseling and shared decision-making (SDM) visit having occurred as part of the written order for lung cancer screening with low-dose computed tomography, and 3) the offering of smoking cessation interventions.
The authors identified facilities in a southwestern state that were listed by either the ACR Lung Cancer Screening Registry or the GO2 Foundation Centers of Excellence. To select facilities, they used 2 purposive sampling approaches: maximum variation sampling and snowball sampling. They surveyed facilities from February to November 2019.
There were 87 facilities contacted, and a total of 63 facilities representing 32 counties across Texas completed the survey. Nearly all facilities used Lung-RADS to classify nodules (92%; n = 58) and submitted data to a CMS-approved registry (92%; n = 57). Most facilities verified that the counseling and SDM visit had occurred (86%; n = 54). Although slightly more than half of the facilities reported always providing self-help cessation materials (68%; n = 42), similar or higher proportions of facilities reported that they never referred smokers to onsite cessation services (68%; n = 42) or quitlines (77%; n = 47), provided cessation counseling (81%; n = 50), or recommended medications (85%; n = 52).
In general, screening facilities are meeting CMS requirements for screening, but they are struggling to offer smoking cessation interventions other than providing self-help materials.
关于筛查机构如何满足医疗保险和医疗补助服务中心（CMS）肺癌筛查报销要求的情况鲜为人知，这些要求包括：1）向CMS批准的登记处（美国放射学会[ACR]肺癌筛查登记处）收集和提交数据；2）核实作为低剂量计算机断层扫描肺癌筛查书面医嘱一部分的咨询和共同决策（SDM）访视是否已进行；3）提供戒烟干预措施。
作者在一个西南部州确定了被ACR肺癌筛查登记处或GO2卓越基金会中心列出的机构。为了选择机构，他们采用了两种目的抽样方法：最大变异抽样和雪球抽样。他们在2019年2月至11月对机构进行了调查。
共联系了87家机构，来自得克萨斯州32个县的63家机构完成了调查。几乎所有机构都使用Lung-RADS对结节进行分类（92%；n = 58）并向CMS批准的登记处提交数据（92%；n = 57）。大多数机构核实咨询和SDM访视已进行（86%；n = 54）。虽然略超过一半的机构报告总是提供自助戒烟材料（68%；n = 42），但类似或更高比例的机构报告他们从未将吸烟者转介至现场戒烟服务（68%；n = 42）或戒烟热线（77%；n = 47），提供戒烟咨询（81%；n = 50）或推荐药物（85%；n = 52）。
总体而言，筛查机构符合CMS的筛查要求，但除了提供自助材料外，它们在提供戒烟干预措施方面存在困难。
