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Free lung cancer screening using low-dose computed tomography (LDCT) became profitable within two years. This analysis of a high-risk screening program shows financial sustainability through downstream revenue, demonstrating value in preventive medicine.

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Area of Science:

  • Medical Economics
  • Preventive Medicine
  • Radiology

Background:

  • Low-dose computed tomography (LDCT) screening is proven for lung cancer in high-risk groups.
  • Program funding sustainability remains a challenge.
  • This study analyzes the profitability of an LDCT screening program using National Comprehensive Cancer Network (NCCN) criteria.

Purpose of the Study:

  • To evaluate the 2.5-year financial performance of a free lung cancer screening program.
  • To assess the impact of using broader NCCN criteria on patient volume and program costs.
  • To determine the program's break-even point and overall profitability.

Main Methods:

  • Retrospective chart review of a free LDCT screening program in the Southeastern US.
  • Patient selection based on NCCN high-risk criteria, encompassing a wider population than CMS criteria.
  • Financial analysis including indirect costs, direct costs, and adjusted net margin, factoring in downstream revenue.

Main Results:

  • 705 scans were performed on 418 patients over 2.5 years.
  • The program transitioned from a net loss of -$212/case in Year 1 to a profit of $177/case in Year 3.
  • A break-even point was achieved between 6-7% indirect cost relative to charges, with new patient acquisition yielding $211/case.

Conclusions:

  • Free lung cancer screening programs can achieve profitability.
  • Downstream revenue from positive screens and other findings is key to financial sustainability.
  • A lag time of approximately 2 years is required to reach profitability.