Fecal occult blood test use by Kansas Medicare beneficiaries

Kimberly K. Engelman, Edward F. Ellerbeck, Jasjit S. Ahluwalia, Niaman Nazir, Alfredo Velasco

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Purpose. The aim of this study was to examine utilization of and trends in fecal occult blood testing (FOBT) among beneficiaries sInc.e Medicare began FOBT coverage on January 1, 1998. Methods. We identified Kansas Medicare beneficiaries ages 65-79. Using Medicare claims, we determined which beneficiaries received FOBT during 1998-1999. We examined demographic variables associated with FOBT and rate changes over time. We linked beneficiaries to primary care practices (PCPs) and examined FOBT variations among 483 PCPs. Results. FOBT use remained unchanged during the study period. Of the 215,322 beneficiaries, 11% received at least one FOBT in 1998 and 11% in 1999; 18% had at least one test during the 2-year period, but only 4% had a test during both years. Caucasians and females had the highest FOBT rates. Although FOBT rates among PCPs ranged from 0 to 71%, only 19% of the practice rates exceeded 10%. Conclusions. Few beneficiaries obtain annual FOBT and little change in rates has occurred sInc.e Medicare reimbursement began. Although FOBT rates vary widely between PCPs, most either do not provide FOBT or do not bill Medicare for FOBT. The FOBT claims rate is much lower than reported in patient surveys and may indicate that Medicare should reexamine its reimbursement policy.

Original languageEnglish (US)
Pages (from-to)622-626
Number of pages5
JournalPreventive medicine
Issue number6
StatePublished - 2001
Externally publishedYes

Bibliographical note

Funding Information:
1Support for this project was provided in part by a grant from the Robert Wood Johnson Foundation Generalist Physicians Faculty Scholars Award (032686) to J. S. Ahluwalia.


  • Colorectal neoplasms
  • Medicare
  • Occult blood
  • Physicians
  • Preventive medicine
  • Primary prevention


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