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April 27, 1998, Vol 158, No. 8 >

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Editor's Correspondence | April 27, 1998

Colon Cancer Screening: Performance and Payments

Lee Sataline, MD
Arch Intern Med. 1998;158(8):928. doi:.
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In their analysis of 2 studies1- 2 of colon cancer screening, Marshall et al3 overlook another major impediment to proper screening, namely, physician reimbursement.

With the advent of capitated managed care, several health maintenance organizations, including Aetna U.S. Healthcare, which participated in one of the aforementioned studies, refuse to pay for sigmoidoscopies performed by primary care physicians. Little wonder, then, that these physicians with ever-dwindling reimbursements and increasing overhead costs have little incentive to perform sigmoidoscopic examinations.

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