Data from Reallocating Cervical Cancer Preventive Service Spending from Low to High-Value Clinical Scenarios

AbstractTimely follow-up care after an abnormal cervical cancer screening test result is critical to the prevention and early diagnosis of cervical cancer. The current inadequate and inequitable delivery of these potentially life-saving services is attributed to several factors, including patient out-of-pocket costs. Waiving of consumer cost-sharing for follow-up testing (e. g. , colposcopy and related cervical services) is likely to improve access and uptake, especially among underserved populations. One approach to defray the incremental costs of providing more generous coverage for follow-up testing is reducing expenditures on ‘low value’ cervical cancer screening services. To explore the potential fiscal implications of a policy that redirects cervical cancer screening resources from potentially low to high-value clinical scenarios, we analyzed 2019 claims from the Virginia All-Payer Claims Database to quantify: 1) total spending on low-value cervical cancer screening and 2) out-of-pocket costs associated with colposcopy and related cervical services among commercially-insured Virginians. In a cohort of 1, 806, 921 female patients (aged 48. 1 + 24. 8 years), 295, 193 claims for cervical cancer screening were reported, 100, 567 (34. 0%) of which were determined to be low-value (4, 394, 361 total; 4, 172, 777 for payers and 221, 584 out-of-pocket 2/patient). Claims for 52, 369 colposcopy and related cervical services were reported (40, 994, 016 total; 33, 457, 518 for payers and 7, 536, 498 out-of-pocket 144/patient). These findings suggest that reallocating savings incurred from unnecessary spending to fund more generous coverage of necessary follow-up care is a feasible approach to enhancing cervical cancer prevention equity and outcomes.