--- title: Medicare Will Pay $50k for Your Heart Attack. It Should... description: The coronary artery calcium (CAC) scan, a 10-minute test costing about $100, can detect coronary atherosclerosis years before a heart attack occurs. In March... canonical: https://daily.dev/posts/medicare-will-pay-50k-for-your-heart-attack-it-should-pay-100-to-prevent-it-reg2gvq2h twitter:card: summary_large_image twitter:site: @dailydotdev og:type: website og:site_name: daily.dev og:title: Medicare Will Pay $50k for Your Heart Attack. It Should Pay $100 to Prevent It | daily.dev og:description: The coronary artery calcium (CAC) scan, a 10-minute test costing about $100, can detect coronary atherosclerosis years before a heart attack occurs. In March... og:url: https://daily.dev/posts/medicare-will-pay-50k-for-your-heart-attack-it-should-pay-100-to-prevent-it-reg2gvq2h og:image: https://api.daily.dev/og/posts/ReG2gVQ2h.png og:image:alt: Medicare Will Pay $50k for Your Heart Attack. It Should Pay $100 to Prevent It og:image:width: 1200 og:image:height: 630 og:locale: en --- > ## Documentation Index > Fetch the complete documentation index at: https://daily.dev/llms.txt > Use this file to discover all available pages before exploring further. # Medicare Will Pay $50k for Your Heart Attack. It Should Pay $100 to Prevent It **[Hacker News](https://daily.dev/sources/hn)** · 5 min read · 1 upvotes · 0 comments ## Summary The coronary artery calcium (CAC) scan, a 10-minute test costing about $100, can detect coronary atherosclerosis years before a heart attack occurs. In March 2026, the American College of Cardiology and American Heart Association finally gave CAC a central role in national prevention guidelines after more than three decades of evidence. A case example describes a 52-year-old patient whose standard risk calculator showed low risk, but whose CAC score of 220 revealed substantial plaque, prompting drug treatment. The authors argue a payment system should spend $100 to avoid a $50,000 emergency, and note AI can identify calcification opportunistically on existing CT scans and is now being used to measure soft plaque. ## Full article daily.dev links to this article rather than hosting it. Read it at the original source: ## Questions this post answers ### What is a coronary artery calcium (CAC) score and what does it measure? A coronary artery calcium score is a 10-minute CT scan, costing about $100, that detects calcified plaque in the arteries and measures the amount of coronary atherosclerosis present. Unlike risk calculators based on age, cholesterol, or blood pressure, it detects the disease itself rather than estimating probability. A score above 100 suggests the patient may benefit from pharmacologic and aggressive lifestyle intervention, while a score of zero can reclassify risk downward. _Anyone weighing statin therapy against test costs can follow coverage and guideline shifts for coronary calcium scoring on daily.dev._ ### Do ACC/AHA guidelines now recommend coronary calcium scanning for heart disease risk assessment? Yes, as of March 2026 the American College of Cardiology and American Heart Association gave the coronary artery calcium (CAC) scan a central role in national guidelines for preventing coronary artery disease. It is recommended for adults with borderline or intermediate risk where the decision to start statins or other preventive therapy is uncertain, following more than three decades of accumulated supporting evidence. _Clinicians tracking how prevention guidelines evolve can follow cardiology policy updates like this on daily.dev._ ### Can AI detect coronary artery calcification from CT scans done for other reasons? Yes, AI-CAC tools can opportunistically identify coronary and vascular calcification on chest CT scans originally ordered for unrelated reasons, standardizing reporting and flagging patients for formal preventive evaluation. This approach is also being extended to measure soft plaque, a precursor to the hard plaque detected by traditional calcium scores, potentially helping identify at-risk patients who cannot afford elective cash-pay testing. _Developers building healthcare AI tools can track how opportunistic screening models are evolving on daily.dev._ ## Community take How the wider developer community reacted, aggregated from 1 discussion and 188 comments across hackernews (as of 2026-10-30). **TL;DR:** Discussion largely drifted away from the CAC scan itself into a broad argument about why the US underinvests in preventive health policy, with threads on race, class, individualism, and healthcare incentives; a smaller but substantive sub-thread debated the actual clinical value and alternatives to the scan. **Sentiment:** 10% positive · 35% mixed · 55% skeptical **The case for** - Some argue opportunistic/inexpensive preventive testing (CAC or blood panels) could meaningfully flag risk that standard calculators miss. - A few note per-capita or capitated payment models could better align incentives toward prevention than fee-for-service. **The pushback** - Several point out that fee-for-service billing financially rewards treating sickness, not preventing it, undermining incentives for scans like this. - Some argue blood panels (ApoB, Lp(a), hs-CRP, HbA1c) are cheaper and more actionable before calcified plaque even appears, questioning why CAC should be the headline test. - One commenter cautions the absolute risk reduction from acting on a CAC result (e.g., starting statins) may be only around 1%, complicating the simple cost-benefit framing. - Many argue the real barrier isn't awareness or technology but cultural/political attitudes (individualism, 'I'm not paying for someone else', race and class dynamics) that block preventive-care investment. **By community** - hackernews (mixed): The thread fragmented into a long, heated debate about US cultural and racial attitudes toward preventive governance, alongside a smaller but more technical discussion questioning whether CAC scans are the best or most cost-effective preventive tool compared to blood panels, with general agreement that incentive structures in US healthcare work against prevention. **Hottest debate:** Whether the practical barrier to preventive care in the US is cultural/economic individualism (and underlying racial dynamics) or simply misaligned financial incentives in fee-for-service healthcare. **Open questions** - How much does acting on a CAC score actually reduce absolute heart attack risk compared to using cheaper blood-based risk markers? - Would restructuring healthcare payment models (capitation vs. fee-for-service) meaningfully increase uptake of preventive testing like CAC scans? **Highlights** > This is a little bit misleading. 'Preventing a heart attack' means taking life long medication to reduce the risk of heart attack by about 1%, which is worth doing, but complicates the maths a little bit. The scan doesn't magically make you healthy or 'much' less likely to have a heart attack > — [dubeye on hackernews · 2 comments](https://news.ycombinator.com/item?id=50305792) > Coronary CT calcium scans are getting more popular. But before getting one, I'd do these simpler tests first: - ApoB - about 20% of people with normal cholesterol results will have abnormal ApoB, and be at risk of heart disease. - Lp(a) - the strongest hereditary risk factor for heart disease. - hs-CRP - inflammation roughly doubles your risk of heart disease - HbA1c - insulin resistance is a risk factor for just about everything. - eGFR - estimates the volume of liquid your kidneys can filter, and is an input to the latest heart disease risk models (PREVENT). These are simple blood tests. You can get them for <$200 through my company or others: https://empirical.health/product/comprehensive-health-panel Imaging is great for detecting calcified plaque in your coronary arteries. But before you have calcified plaque, the above risk factors tell you about the buildup of soft plaque. And 4 out of 5 of them are modifiable through lifestyle, exercise, and medication. > — [brandonb on hackernews · 2 comments](https://news.ycombinator.com/item?id=50304521) > Nobody likes to say this out loud, but because the US healthcare system is largely based on “fee for service” billing, it is true by definition that the sicker the patients are, the more profit the providers make. So incentives for actually making people healthier have to be imposed in indirect ways. There are some pockets of “per capita” payment, where the provider gets a fixed amount per person and is thus encouraged to reduce treatment costs, which indirectly should encourage preventative care, but also encourages just refusing to treat people. We could remove these weird constraints by making health care a government service rather than a highly contorted pseudo-market, but that would not be the American way. It has to at least look like a market, even if it’s an ineffective, inefficient, opaque, corrupt one. > — [wrs on hackernews · 2 comments](https://news.ycombinator.com/item?id=50305677) > I'm interested in this intersection of technical problems where we already have the tech to solve it, but the bottlenecks are social/legal/financial incentive. Recently there was an old lady in the family that had an appendicitis, an ambulance rejected her, and the next day it got worse, and at that point she was accepted, but it was a bit too late. One hypothesis is that triaging is hard and there's a lot of demand so things only go in when it's bad enough (considering there was medical insurance, they aren't charging per patient, so there's no incentive to take on more patients). But if that were the case, then preventive measures would actually reduce the total burden on their system. The more cynical hypothesis that I'm holidng is that that health system is maximizing for work, if there's 10 appendicitis per month, and they are all handled in time, that's maybe like 5 hours of billable hours per patient? But if the appendicitis becomes bad enough and there's a puncture, then you have infections, complications, the patients have to stay for weeks and often come back for checkups, we are looking at maybe 100 billable hours? So the financial incentive is there. In that sense what I want to add is that the title would be completely wrong, the solution is not for the hospital to pay 100$ for prevention, but for prevention to be more accurately priced, we should be paying 50k, and maybe even 100k for prevention, because we value it more than emergency action. In a broader economic sense, there's a lot of cases where there's a huge difference between the cost and the value, Shkreli got a lot of heat for surging up medicine prices, but I don't think it's immediately obvious that something should be valued in proportion to what it costs. Maybe if we price heart prevention at 100K, there would be more incentive for everyone involved to just get a fucking pill to those in need, imagine how many people would jump at that opportunity to make it happen, call centers, bureocrats, NOC support, legal teams, all dedicated to making sure a pill gets to the patient before a heart attack does. > — [TZubiri on hackernews · 1 comments](https://news.ycombinator.com/item?id=50305434) > It's easy to understand. US optimizes for whatever helps with more overall spending. They can print money and export inflation to others. All this new money then goes to the companies that hold power through lobbying. > — [raz32dust on hackernews](https://news.ycombinator.com/item?id=50305819) **Source threads** - [hackernews](https://news.ycombinator.com/item?id=50304419) · 100 points · 188 comments ## Similar posts on daily.dev - [AI analysis of CT scans finds 42.9% of patients have coronary inflammation](https://daily.dev/posts/ai-analysis-of-ct-scans-finds-42-9-of-patients-have-coronary-inflammation-xhxrtitz2) · Hacker News · 0 upvotes · 0 comments - [An AI reads an ECG in two seconds and finds what cardiologists cannot](https://daily.dev/posts/an-ai-reads-an-ecg-in-two-seconds-and-finds-what-cardiologists-cannot-snmfkwqri) · The Next Web · 0 upvotes · 0 comments - [A portable ultrasound sensor may enable earlier detection of breast cancer](https://daily.dev/posts/a-portable-ultrasound-sensor-may-enable-earlier-detection-of-breast-cancer-tfhstnnvk) · MIT News · 0 upvotes · 0 comments - [Hackaday Europe 2026: Is Your Blood Pressure Monitor Lying To You?](https://daily.dev/posts/hackaday-europe-2026-is-your-blood-pressure-monitor-lying-to-you--wh8pgioxb) · Hackaday · 0 upvotes · 0 comments --- [View this post on daily.dev](https://daily.dev/posts/medicare-will-pay-50k-for-your-heart-attack-it-should-pay-100-to-prevent-it-reg2gvq2h) ```json {"@context":"https://schema.org","@graph":[{"@type":"Organization","@id":"https://daily.dev/#organization","name":"daily.dev","url":"https://daily.dev","logo":{"@type":"ImageObject","url":"https://daily.dev/apple-touch-icon.png","width":180,"height":180},"sameAs":["https://twitter.com/dailydotdev","https://github.com/dailydotdev","https://www.linkedin.com/company/daily-dev-ltd"]},{"@type":"WebSite","@id":"https://daily.dev/#website","url":"https://daily.dev","name":"daily.dev","publisher":{"@id":"https://daily.dev/#organization"},"potentialAction":{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https://daily.dev/search?q={search_term_string}"},"query-input":"required name=search_term_string"}}]} {"@context":"https://schema.org","@type":"TechArticle","headline":"Medicare Will Pay $50k for Your Heart Attack. 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