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

Billings Clinic

Lung screening gap across 19 counties in Montana and Wyoming

19,000to35,000adults in its service area qualify for lung cancer screening and are not being screened

About 260 people here are diagnosed with lung cancer each year, and 62% are found at a late stage, when it is hardest to treat.

Explore the screening network
IDMTSDNENDWY
19 counties13 acute care hospitalsService area
22,000 to 40,000adults likely qualify under USPSTF 2021 criteria (estimate)
150lung cancer deaths a year in these counties, 2020 to 2024
13.0%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 Billings Clinic'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.

Adults likely eligible, per neighborhood

0+180+230+290+340+390+490+

Acute care hospital in this system

Counties in the service area

CountyStateAdults likely eligibleLung cancer deaths per 100kMedicare screens billed locally, 2024
Yellowstone CountyMontana7,700 to 13,20026.3115
Gallatin CountyMontana3,300 to 7,60016.8378
Park CountyWyoming1,500 to 3,10021.238
Sheridan CountyWyoming1,600 to 3,10030.7137
Park CountyMontana980 to 1,70023.2None billed locally
Carbon CountyMontana680 to 1,20016.3None billed locally
Big Horn CountyWyoming670 to 1,10030.0None billed locally
Big Horn CountyMontana880 to 1,10030.6None billed locally
Fergus CountyMontana680 to 1,10029.5None billed locally
Stillwater CountyMontana520 to 1,00028.8None billed locally
Roosevelt CountyMontana620 to 83036.0None billed locally
Rosebud CountyMontana550 to 830—None billed locally
Dawson CountyMontana420 to 820—None billed locally
Washakie CountyWyoming460 to 81026.1None billed locally
Valley CountyMontana390 to 74032.8None billed locally
Musselshell CountyMontana370 to 56036.4None billed locally
Sweet Grass CountyMontana210 to 360—None billed locally
Sheridan CountyMontana200 to 320—None billed locally
Daniels CountyMontana80 to 190—None billed locally

15 of the 19 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 13.0% to the national rate of 18.2%, about 1,100 to 2,000 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 62% 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

260new lung cancers
160found at a late stage
150lung cancer deaths

NCI and CDC State Cancer Profiles, annual averages.

Screening at Billings Clinic today

Public Medicare claims do not attribute lung screening reads to Billings Clinic locations. Radiologists who read for a health system often bill through a separate radiology group, so Billings Clinic's screening volume is best measured from its own records.

Most adults who qualify see a primary care clinician every year. We count 385 primary care clinicians, 17 pulmonologists and 3 thoracic surgeons practicing at Billings Clinic 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 Billings Clinic 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 (26%, CMS) and, at the high end, by the share of eligible adults under 65 (61%).

13 acute care hospitals

  • Billings ClinicBillings, MT
  • Daniels Memorial HospitalScobey, MT
  • Livingston HealthcareLivingston, MT
  • Pioneer Medical CenterBig Timber, MT
  • Powell Valley Health CarePowell, WY
  • Stillwater Billings ClinicColumbus, MT
  • North Big Horn HospitalLovell, WY
  • Beartooth Billings ClinicRed Lodge, MT
  • Beartooth Billings ClinicRed Lodge, MT
  • Daniels Memorial Healthcare CenterScobey, MT
  • Livingston HealthcareLivingston, MT
  • Stillwater Hospital Association IncColumbus, MT

And 1 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 Billings Clinic 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 Billings Clinic'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