Higher breast cancer screening rates seen after copayments were eliminated, research shows

por Lauren Dubinsky, Senior Reporter | January 22, 2018
Insurance Rad Oncology Women's Health
ACA opposition could
threaten these findings
Eliminating mammogram copayments may be the key to boosting screening rates, according to a new study published in the New England Journal of Medicine.

"Prior to the ACA, Medicare Advantage plans could charge copayments for screening mammograms," Dr. Amal N. Trivedi, lead author, told HCB News. "We are not able to determine why some plans elected to impose copayments and others did not."

The U.S. Preventive Services Task Force recommends that women between the ages of 50 and 74 undergo screening mammography every two years. But organizations including the American College of Radiology and the American Cancer Society advocate for annual screening starting at age 40.

Trivedi and his team studied biennial screening mammography data among 15,085 women ages 65 to 74 with Medicare Advantage plans that eliminated copayments and 52,035 women with MA plans that had and maintained full coverage.

They found that screening rates among the MA plans that did away with cost sharing increased by 6 percent, compared with plans that maintained full coverage for the service.

"We think this is a meaningful increase," said Trivedi. "The 6 percentage point increase represents a 10% relative improvement in screening rates for the plans that had to eliminate copayments."

The greatest gains were seen in women with more education. In addition, the absence of copayments had no effect on screening rates for Hispanic women.

Latino patients have been found to have less awareness of the ACA than the general population, according to the researchers. This shows that the industry has work to do to create more awareness of the cost-sharing provisions of the ACA.

"These results suggest that removing copayments for high-value preventive services can promote their uptake," said Trivedi. "The study findings call for understanding why women with lower educational attainment and Hispanic women did not experience the same gains in screening rates after the elimination of copayments."

However, the ACA is facing ongoing opposition among some lawmakers and the researchers are concerned that if the cost-sharing provisions are retracted, fewer older women will undergo recommended screening. In previous studies, the team revealed that copayments of around $20 led to an up to 11 percent drop in breast cancer screening rates.

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