A tentative decision to end Medicare coverage for virtual colonoscopies because "there is not enough evidence" that they would benefit individuals ages 65 and older "may be a disappointment for older Americans who would prefer a virtual exam to a real one," but "those sort of judgments will be fundamental to any successful health care reform effort," a New York Times editorial states (New York Times, 2/28).

CMS announced the tentative decision last month. According to a notice published on the CMS Web site, an analysis conducted by the agency found "insufficient evidence" to conclude that virtual colonoscopies "improve outcomes in Medicare beneficiaries." Many previous studies that supported use of virtual colonoscopies involved participants with an average age of 58 and, as a result, the research might not apply to the older Medicare population, CMS said. CMS will make a final decision on Medicare coverage for virtual colonoscopies after a 30-day public comment period (Kaiser Daily Health Policy Report, 2/13).

"Even if Medicare decides that virtual colonoscopies are clinically effective, it would then need to determine whether they are cost-effective compared with other screening options," the editorial states, adding, "They do not appear to be at current prices." In addition, the editorial states, "Eliminating unproven procedures and reducing needless costs is necessary if the nation is to improve the quality and lower the cost of care overall" (New York Times, 2/28).