Offering imaging exam for free ups utilization by 546%, with key gains in underserved populations

Offering CT coronary artery calcium screening at no cost led to a 546% average monthly increase in the use of the test, experts reportedly recently.

Providers typically use such scans to help predict a patient’s risk of heart attack, stroke or cardiovascular death. But CAC screening can cost between $400 and $800, with insurers typically not covering the exam, noted experts with University Hospitals Health System in Cleveland.

Wanting to boost the use of this “crucial” screening tool, the Ohio institution in 2017 started offering coronary artery calcium tests for free. And it’s logged impressive numbers a few years in, with key gains among women, minorities and patients from lower-income ZIP codes, researchers reported in the Journal of the American College of Cardiology.

“This study shows what we hoped would be the case: More patients undergo testing when that testing comes at no cost to them,” study co-author Sanjay Rajagopalan, MD, chief of cardiovascular medicine at UH Cleveland Medical Center, said Monday. “The fact that more people, especially women and socioeconomically disadvantaged segments, utilize this test at no cost is very meaningful,” he added.

To reach their conclusions, Rajagopalan and colleagues analyzed data from 27,466 patients treated across 21 radiology locations in Northeast Ohio. Those included 5,109 treated during the initial phase when University Hospitals only charged $99 for a CAC test and another 22,357 who paid nothing for the imaging exam.

Along with the fivefold surge in visits, the health system also saw increases in the age of patients treated from (from 57.9 up to 59.3), women (from 46% to 51%), and Black patients (7.2% up to 9.4% following the price elimination). Plus, the intervention also contributed to reclassification of statin eligibility, changes in preventive medications, and improvement to risk factors, the authors noted.

“Making this screening no-cost improves access for everyone, but especially minorities and those with lower incomes,” Dan Simon, MD, University Hospital’s chief clinical and scientific officer, said in a statement.

You can read more on their findings in the Journal of the American College of Cardiology here.

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