Expanded Medicare screening coverage was associated with a 23.4% increase in the mean monthly volume of HbA1c tests among patients aged ≥65 years (p <0.001).
Observational
Does expanded Medicare screening coverage increase the volume of HbA1c testing in patients aged ≥65 years?
Expanded Medicare coverage for HbA1c screening significantly increased testing volumes among older adults, particularly those without a prior diabetes diagnosis.
Effect estimate: 23.4% increase
p-value: p=<0.001
Introduction and Objective: Prior to 2024, HbA1c testing in the United States was only intended for diabetes glycemic monitoring and management, not for diagnostic or screening purposes, as per Medicare policy. In 2024, a policy change allowed screening for diabetes with HbA1c, in addition to fasting plasma glucose and oral glucose tolerance tests. We assessed if this policy change impacted HbA1c testing usage. Methods: Quest Diagnostics analyzed monthly HbA1c testing volumes before and after this policy change, comparing the periods January 2022-September 2023 (Period 1) and January 2024-September 2025 (Period 2). The study population consisted of patients aged ≥65 years. Results from male patients comprised 46% of tests. Results: The mean monthly number of tests in the total population increased by 23.4% in Period 2 compared to Period 1 (p 0.001) (Table). Among patients without diagnoses of type 1 or type 2 diabetes, the mean monthly tests rose by 30.1% (p 0.001). Conclusion: In summary, there was an increase in average monthly volume of HbA1c testing in patients aged ≥65 years following expanded Medicare screening coverage. A greater increase occurred in patients without diabetes. Further studies are needed to assess whether increased HbA1c testing in patients without diabetes results in earlier diagnoses, which may improve health and economic outcomes. Disclosure J. Szymonifka: None. Z. Chen: Employee; Current; Quest Diagnostics. Stock/Shareholder; Current; Quest Diagnostics. F.D. Warren II: Employee; Current; Quest Diagnostics. J.M. Ng: Research Support; Ended; Sanofi-Aventis U.S. S.B. Dixit: Employee; Current; Quest Diagnostics.
Szymonifka et al. (Fri,) conducted a observational in Diabetes screening. Expanded Medicare screening coverage vs. Prior Medicare policy (January 2022-September 2023) was evaluated on Mean monthly number of HbA1c tests (23.4% increase, p=<0.001). Expanded Medicare screening coverage was associated with a 23.4% increase in the mean monthly volume of HbA1c tests among patients aged ≥65 years (p <0.001).