The Hidden Cost of Missed Screenings: How Early Detection Saves Money and Lives

One in three eligible women skips their recommended mammogram, even though it is available to them for $0 out-of-pocket costs. Behind this statistic lies a sobering reality for employers: preventable healthcare costs and potentially life-altering consequences for your workforce.

Mammogram Coverage Under Threat

As employers weigh the benefits of preventive care, a critical Supreme Court case threatens to upend access to no-out-of-pocket cost mammograms. On April 21, 2025, the Supreme Court heard arguments in Kennedy v. Braidwood Management, challenging the Affordable Care Act's requirement that insurers cover preventive services without cost share. If the Court rules in favor of Braidwood, private insurers would no longer be required to cover preventive services recommended since the ACA's passage. The Supreme Court will likely issue its ruling by June 2025.

This case could directly impact mammogram access for over 150 million Americans by potentially reintroducing financial barriers to screening. With mammograms costing $100-$250 for 2D and up to $1,000 for 3D, many women aged 40 and over would face difficult financial decisions about preventive care.

The Financial Impact Is Clear

The numbers tell a compelling story. While breast cancer screening compliance improved from 59.8% in 2021 to 64.2% in 2023, over a third of women still miss these critical screenings. This matters to your bottom line.

Treatment costs for unscreened patients ultimately diagnosed with breast cancer jumped 21.7% over the past three years—almost double the 13.6% increase for those who were diagnosed through routine screenings. In real dollars, the average breast cancer episode for unscreened women costs $25,765—18% higher than the $21,757 for screened patients.

But that's just the beginning.

Late Detection Doubles Costs—And Risk

When cancer progresses undetected, consequences multiply. Women without regular screenings are twice as likely to reach advanced stages (8.92% vs. 3.79%), and their treatment costs soar to $120,485/year—a $44,029 premium over screened patients at the same stage.

And the cost to your workforce isn’t only measured in medical and Rx spend. Late screenings and late detected cancers result in extended employee absences, higher disability claims, increased staffing costs, and greater retention risks that impact your entire organization.

Your Workforce Demographics Drive Screening Needs

The face of your workforce is changing:

• Generation X (44-59 years old): Currently your most engaged group—making up 59% of screenings despite being only 21% of the workforce.

• Millennials (28-43 years old): Now your largest workforce generation (29% of enrolled females), with screening rates that have tripled from 4% to 15% as they reach recommended screening age.  

This demographic shift creates both challenge and opportunity. Employers who prioritize preventive care today will reap future rewards.  

Technology Isn't the Barrier—Engagement Is

Good news: Advanced screening technology is widely accessible. Today, 92% of mammograms use superior 3D technology (up from 76% in 2020), and 99.5% of employer health plans cover this improved screening method.

3D mammography detects 40% more invasive cancers than traditional methods while reducing false alarms. The surprising part? Even as technology has advanced, cost increases have remained moderate—3D mammograms saw just a 9.24% increase over four years.

The obstacle isn't technology. It's engagement. And, if the Supreme Court rules in favor of Braidwood, cost could also become prohibitive for many.

Why direct healthcare contracts are now essential: Traditional insurance models leave you vulnerable to regulatory shifts. Direct contracting gives you control regardless of court decisions, ensuring your workforce maintains access to life-saving preventive care while reducing costs by an average of 30%.

Smart Employers Are Taking Action, Regardless of the Court Ruling

Forward-thinking companies tackle these challenges through two complementary approaches:

• Analytics-Driven Insights and Interventions: Identify screening gaps, uncover disparities in access, and leverage social determinants of health data to create targeted, effective interventions before costs escalate. Data analytics helps you precisely target resources where they'll have maximum impact, delivering measurable ROIs.

• Direct Healthcare Networks: Reduce screening costs by an average of 30% through direct provider partnerships while eliminating financial barriers like copays and deductibles for employees.

The most successful programs combine analytics with direct provider relationships to deliver comprehensive coverage that includes screening, follow-up testing, and care navigation with no out-of-pocket costs – protecting your workforce regardless of how the Supreme Court rules.

The Bottom Line

Every missed screening carries a price tag—one that affects both your healthcare costs and your employees' lives. By making preventive care more accessible, you drive earlier detection, improve outcomes, and create a healthier, more productive workforce.

The cost of missed screenings isn't measured just in dollars—it's measured in lives. And employers have the power to change that equation.

This blog is based on a comprehensive analysis conducted by Artemis, a Nomi Health company, examining breast cancer screening and treatment data for women ages 40-74 from January 2021 through December 2023.