Impact of removing cost sharing under the affordable care act (ACA) on mammography and pap test use

Autor: M. Mahmud Khan, Abeer Al-Harbi, Ronnie D. Horner, Cole G. Chapman, Heather M. Brandt
Rok vydání: 2019
Předmět:
Counterfactual thinking
Screening test
Cost-sharing
media_common.quotation_subject
030209 endocrinology & metabolism
Affordable care act
Medicare
Insurance Coverage
Preventive care services
03 medical and health sciences
0302 clinical medicine
Preventive Health Services
Cancer screenings
Health insurance
Humans
Mass Screening
Pap tests
Medicine
Mammography
030212 general & internal medicine
Pap test
Cost Sharing
skin and connective tissue diseases
media_common
Vaginal Smears
Insurance
Health
Actuarial science
Variables
medicine.diagnostic_test
business.industry
lcsh:Public aspects of medicine
Health Policy
Patient Protection and Affordable Care Act
Administrative Personnel
Public Health
Environmental and Occupational Health
food and beverages
lcsh:RA1-1270
Patient Acceptance of Health Care
United States
eye diseases
stomatognathic diseases
Cost sharing
Female
Biostatistics
business
Papanicolaou Test
Research Article
Zdroj: BMC Public Health
BMC Public Health, Vol 19, Iss 1, Pp 1-9 (2019)
ISSN: 1471-2458
DOI: 10.1186/s12889-019-6665-9
Popis: Background The Affordable Care Act (ACA) required private insurers and Medicare to cover recommended preventive services without any cost sharing to improve utilization of these services. This study is an attempt to identify the impact of removing cost sharing on mammography and pap test utilization rates. Methods Counterfactual analysis was used to predict what would have been the screening rates in post-ACA if ACA was not there. This was done by estimating a model that examines determinants of dependent variable for the pre-ACA year (pre-ACA year is 2009). The estimated model was then used to predict the dependent variable for the post-ACA year using individual characteristics and other relevant variables unlikely to be affected by ACA (post-ACA year is 2016). Effect of ACA is defined as the difference between the values of dependent variables in post-ACA and the predicted values of dependent variables in the post-ACA year using counterfactual. Results The counterfactual analysis show that the utilization of mammogram and pap test did not improve following ACA. Conclusion Removal of cost-sharing under the ACA did not improve mammography or pap test rates. Therefore, financial barrier may not be an important factor in affecting utilization of the screening tests and policy makers should focus on other non-financial barriers in order to improve coverage of the tests.
Databáze: OpenAIRE
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