What can ASCs do to make patients better understand the screening procedures? DEAS: People need to be better informed about the risk of colon can- cer—the second most common cause of cancer death in the US—and the value of screening methods in pre- venting colon cancer. Certainly, ASCs can take an active role in their com- munities to inform the public. In many cases, the ASC provides a more comfortable, time-efficient, patient- preferred, low-cost alternative for screening colonoscopy. This more patient-friendly, welcoming environ- ment might help some patients over- come their resistance to colonoscopy.

How can ASCs promote access to colorectal cancer screening? DEAS: Working with federally qualified health centers and charitable health care systems and clinics, many ASCs also provide colonoscopy services in their communities at minimal or no cost for uninsured and under-served patients. It is an opportunity for ASCs to give back to their community and save lives by preventing colon cancer. The fact that ASCs provide a lower cost alternative to the hospital facility setting increases access even for many insured patients with health savings accounts (HSA), high co-pays, or deductible plans. In many communities the added capacity that ASCs provide for colonoscopy also promotes access.

How does advocacy play a role in colorectal cancer prevention? DEAS: Advocacy has been absolutely vital in the effort to prevent colon cancer. As a result of very aggressive advocacy for screening, Medicare and virtually all commercial health plans now cover colorectal cancer screen- ing at little or no cost for patients at appropriate intervals. Legislation to further reduce potential out-of-pocket costs for Medicare patients is currently


being considered with the Remov- ing

Barriers to Colorectal Cancer

Screening Act. Medicare patients who undergo screening expect that they will have no co-pay or deductible costs based on their coverage. If a polyp is removed, however, Medicare declares the procedure to have been “diagnos- tic” rather than “screening,” requiring the patient to assume unexpected out- of-pocket costs. This bill would elim- inate unexpected costs for Medicare beneficiaries when a polyp is discov- ered and removed, ensuring that unex- pected copays do not deter a patient from having the screening performed. The Removing Barriers to Colorec- tal Cancer Screening Act has received strong advocacy and bipartisan sup- port for many years but has yet to be passed by Congress. As health care continually evolves, advocacy is criti- cal to moving the advancements in the mainstream of care.

Should ASCs engage patient advocacy groups locally? If so, do you have any recommendations for them? DEAS: Most of the advocacy efforts for CRC screening have been at the state and national level as the coverage for CRC screening is driven by Medicare, Med- icaid and commercial health plans. I would certainly encourage gastrointesti- nal endoscopists and ASCs to be active in these advocacy efforts by financially supporting the advocacy efforts and by becoming one of the influential voices in Washington, DC, or their state capitals. Additionally, many local advocacy

groups host events to raise awareness on the importance of colorectal cancer screening. I would encourage ASCs to participate in walk-a-thons, health fairs and other local events that can increase visibility on this important issue.

Kristin Murphy is ASCA’s assistant director of legislative affairs. Write her at

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