Oatmeal Healthoatmealhealth.com · public-data estimate, October 2026

Avera Health

Lung screening gap across 47 counties in Iowa, Minnesota, Nebraska and South Dakota

31,000to51,000adults in its service area qualify for lung cancer screening and are not being screened

About 560 people here are diagnosed with lung cancer each year, and 65% are found at a late stage, when it is hardest to treat.

Explore the screening network
WIILMTMNIASDNENDWY
47 counties39 acute care hospitalsService areaShowing the Iowa, Minnesota, Nebraska and South Dakota region; all regions are mapped below.
38,000 to 63,000adults likely qualify under USPSTF 2021 criteria (estimate)
320lung cancer deaths a year in these counties, 2020 to 2024
18.5%of eligible adults screened in these states, vs 18.2% nationally

Estimates from public data only; no patient information. Sources and method below.

Where the eligible adults live

The counties where most of Avera Health's Medicare inpatients live. Darker areas hold more adults who likely qualify, which is where outreach would start. Hover or tap any area for its estimate.

Iowa, Minnesota, Nebraska and South Dakota

Nebraska

Adults likely eligible, per neighborhood

0+190+220+260+290+320+390+

Acute care hospital in this system

Counties in the service area

CountyStateAdults likely eligibleLung cancer deaths per 100kMedicare screens billed locally, 2024
Minnehaha CountySouth Dakota8,500 to 14,10040.9837
Lincoln CountySouth Dakota2,500 to 3,90026.5None billed locally
Brown CountySouth Dakota1,700 to 3,20029.390
Sioux CountyIowa1,300 to 2,40018.5None billed locally
Codington CountySouth Dakota1,600 to 2,30033.281
Brookings CountySouth Dakota960 to 2,10031.8None billed locally
Plymouth CountyIowa1,300 to 2,10034.0None billed locally
Yankton CountySouth Dakota1,200 to 2,00022.358
Lyon CountyMinnesota1,100 to 1,80038.5None billed locally
Dickinson CountyIowa1,000 to 1,70023.1None billed locally
Davison CountySouth Dakota1,100 to 1,70026.012
Beadle CountySouth Dakota960 to 1,60027.411
Nobles CountyMinnesota1,000 to 1,60029.7None billed locally
Hughes CountySouth Dakota820 to 1,50033.5111
Clay CountyIowa880 to 1,40022.5None billed locally
Lake CountySouth Dakota510 to 1,30035.2None billed locally
Lyon CountyIowa600 to 90019.9None billed locally
Holt CountyNebraska510 to 89038.0None billed locally
Emmet CountyIowa520 to 89028.8None billed locally
Yellow Medicine CountyMinnesota550 to 84032.9None billed locally
Charles Mix CountySouth Dakota600 to 81025.8None billed locally
Murray CountyMinnesota450 to 78021.5None billed locally
Knox CountyNebraska490 to 78034.7None billed locally
Howard CountyIowa550 to 78039.4None billed locally
Pipestone CountyMinnesota510 to 77041.4None billed locally
Turner CountySouth Dakota450 to 76026.3None billed locally
Rock CountyMinnesota500 to 76038.3None billed locally
Cedar CountyNebraska380 to 71035.4None billed locally
Grant CountySouth Dakota400 to 68027.2None billed locally
Hutchinson CountySouth Dakota360 to 650—None billed locally
Spink CountySouth Dakota340 to 640—None billed locally
Bon Homme CountySouth Dakota440 to 620—None billed locally
Moody CountySouth Dakota320 to 610—None billed locally
Osceola CountyIowa380 to 55033.9None billed locally
Tripp CountySouth Dakota380 to 520—None billed locally
Lincoln CountyMinnesota320 to 480—None billed locally
Kingsbury CountySouth Dakota280 to 48035.9None billed locally
Marshall CountySouth Dakota240 to 460—None billed locally
McCook CountySouth Dakota280 to 46052.4None billed locally
Dewey CountySouth Dakota390 to 460—None billed locally
Gregory CountySouth Dakota250 to 410—None billed locally
Stanley CountySouth Dakota150 to 340—None billed locally
Hand CountySouth Dakota150 to 310—None billed locally
Frontier CountyNebraska120 to 250—None billed locally
Potter CountySouth Dakota140 to 230—None billed locally
McPherson CountySouth Dakota160 to 230—None billed locally
Jerauld CountySouth Dakota90 to 230—None billed locally

40 of the 47 counties had no Medicare lung screening reads billed from a local address in 2024. County names link to their Missing Millions page.

What closing the gap would mean

If screening in these counties rose from 18.5% to 23.5%, five points above today, about 1,900 to 3,200 more people would be screened each year.

In the National Lung Screening Trial, low-dose CT screening lowered lung cancer deaths by 20% compared with chest X-ray. Today about 65% of lung cancers here are found at a late stage.

Illustrative estimate: eligible adults (range) times the change in screening rate. Not a forecast or a guarantee.

Each year in these counties

560new lung cancers
360found at a late stage
320lung cancer deaths

NCI and CDC State Cancer Profiles, annual averages.

Screening at Avera Health today

Clinicians at Avera Health locations billed 611 low-dose CT lung screening reads to Medicare fee-for-service in 2024. Including Medicare Advantage and other insurers, we estimate about 940 to 2,500 screenings a year.

Most adults who qualify see a primary care clinician every year. We count 1,012 primary care clinicians, 15 pulmonologists and 6 thoracic surgeons practicing at Avera Health locations. A 20 pack-year smoking history is often missing from structured EHR fields, so many eligible patients are never flagged.

CMS Medicare Physician and Other Practitioners 2024 (CPT 71271); clinicians matched to Avera Health by practice address using the AHRQ Compendium of U.S. Health Systems 2023, so reads billed by outside radiology groups are not included. The all-payer estimate scales Medicare fee-for-service by the local Medicare Advantage share (35%, CMS) and, at the high end, by the share of eligible adults under 65 (63%).

39 acute care hospitals

  • Avera MckennanSioux Falls, SD
  • Avera St. LukesAberdeen, SD
  • Avera St MarysPierre, SD
  • Lakes Regional HealthcareSpirit Lake, IA
  • Avera Sacred Heart HospitalYankton, SD
  • Avera Hand County Memorial Hospital and ClinicMiller, SD
  • Avera Marshall Regional Medical CenterMarshall, MN
  • Avera St. Anthonys HospitalO'neill, NE
  • Avera St. Benedict Health CenterParkston, SD
  • Floyd Valley HospitalLe Mars, IA
  • Freeman Regional Health ServicesFreeman, SD
  • Avera Granite FallsGranite Falls, MN

And 27 more acute care hospitals.

Find them, reach them, give radiologists a second opinion

LungIQ Find

Reads clinical notes, diagnoses and medications in the EHR and returns a ranked list of patients likely eligible, including those whose pack-year history is missing. Start with a CSV export refreshed every 1, 3 or 6 months, or connect through FHIR or HL7.

LungNAV Reach

An AI patient navigator that texts and calls patients in 70+ languages, answers questions about the scan, and hands each patient to your scheduling team or nurse navigators with a call summary.

LungAI Second opinion

Gives radiologists a malignancy risk score for each nodule, factoring in change since the prior scan, inside the PACS and CADe software they already use. The radiologist makes the final call.

LungAI is an investigational medical device and has not been cleared by FDA. It is not commercially available in the United States.

How we estimate the gap

Modeled estimates from public data. They are not a count of Avera Health patients and contain no patient information.

  • Service area: CMS Hospital Service Area File 2025 (counties within 120 miles of a system hospital holding 80% of its Medicare inpatients, plus any county with at least 1%); hospitals from the AHRQ Compendium of U.S. Health Systems, 2023.
  • Eligible adults, low estimate: Oatmeal Health Missing Millions (Census 2025 population, CDC PLACES smoking, USPSTF 2021).
  • Eligible adults, high estimate: University of Minnesota National Lung Cancer Screening Estimates (Haynes 2026), which also counts former smokers.
  • Screening rate: American Lung Association, State of Lung Cancer 2025.
  • Lung cancer cases and deaths: NCI and CDC State Cancer Profiles (incidence 2019 to 2023, deaths 2020 to 2024).
  • Screening volume: CMS Medicare Physician and Other Practitioners, 2024; CMS Medicare Advantage State/County Penetration, September 2026.

LungAI is an investigational medical device and has not been cleared by FDA. Oatmeal Health is preparing a 510(k) premarket notification. LungAI is not commercially available in the United States.

See Avera Health's own numbers

In a 30 minute review we replace these public estimates with counts from your own records and agree on what a first program would look like.

Request a private screening review