Poor Adherence to Shared Decision-Making Discussion Before Lung Cancer Screening

Since 2015, Medicare has required a shared decision-making (SDM) discussion — and provided reimbursement for an SDM visit — before low-dose computed tomography (LDCT) for lung cancer screening. In this study, researchers assessed how frequently SDM visits occurred among 19,000 Medicare patients who had LDCT screening in 2016.

According to Medicare claims, only 9% of the patients who underwent LDCT screening had dedicated SDM visits during the previous 3 months. Black and female enrollees, and those with higher levels of education, were less likely to have SDM visits before screening than were enrollees who were white, were male, and had lower educational levels. Among those who did have SDM visits, 61% decided to undergo LDCT screening.