Opt-out hepatitis C screening in ERs gains traction as key to elimination

King’s College Hospital in south London has instituted automatic hepatitis B and C testing for anyone having blood drawn in its emergency department, with signage informing patients that the screening is part of standard care. This opt-out model, now in place at 90 hospitals across England, is helping the nation move toward its 2030 target of eliminating hepatitis C as a public-health threat. In the United States, emergency-medicine doctors such as Aimee Moulin promote expanding comparable testing to reach high-risk populations that seldom access primary care.

Challenges include ensuring diagnosed individuals receive treatment and securing consistent insurance reimbursement for both testing and the peer or navigator services that facilitate follow-up. England addresses the follow-up gap by embedding peer workers who have completed treatment themselves, while California’s $15 million Bridge program funds patient navigators to support post-discharge care. Congressional bills sponsored by Bill Cassidy and Mariannette Miller-Meeks seek federal funding for a nationwide hepatitis C elimination program that would back such screening and linkage-to-care efforts. Experts contend that routine, stigma-free testing in emergency settings could be pivotal to achieving widespread cure.