Background: The Affordable Care Act (ACA) required most insurers and the Medicare program to eliminate cost sharing for screening mammography.
Methods: We conducted a difference-in-differences study of biennial screening mammography among 15,085 women 65 to 74 years of age in 24 Medicare Advantage plans that eliminated cost sharing to provide full coverage for screening mammography, as compared with 52,035 women in 48 matched control plans that had and maintained full coverage.
Results: In plans that eliminated cost sharing, adjusted rates of biennial screening mammography increased from 59.9% (95% confidence interval [CI], 54.9 to 65.0) in the 2-year period before cost-sharing elimination to 65.4% (95% CI, 61.8 to 69.0) in the 2-year period thereafter. In control plans, the rates of biennial mammography were 73.1% (95% CI, 69.2 to 77.0) and 72.8% (95% CI, 69.7 to 76.0) during the same periods, yielding a difference in differences of 5.7 percentage points (95% CI, 3.0 to 8.4). The difference in differences was 9.8 percentage points (95% CI, 4.5 to 15.2) among women living in the areas with the highest quartile of educational attainment versus 4.3 percentage points (95% CI, 0.2 to 8.4) among women in the lowest quartile. As indicated by the difference-in-differences estimates, after the elimination of cost sharing, the rate of biennial mammography increased by 6.5 percentage points (95% CI, 3.7 to 9.4) for white women and 8.4 percentage points (95% CI, 2.5 to 14.4) for black women but was almost unchanged for Hispanic women (0.4 percentage points; 95% CI, -7.3 to 8.1).
Conclusions: The elimination of cost sharing for screening mammography under the ACA was associated with an increase in rates of use of this service among older women for whom screening is recommended. The effect was attenuated among women living in areas with lower educational attainment and was negligible among Hispanic women. (Funded by the National Institute on Aging.).
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842919 | PMC |
| http://dx.doi.org/10.1056/NEJMsa1706808 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Use and Costs of Supplemental Benefits in Medicare Advantage, 2017-2021.
JAMA Netw Open
January 2025
Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts.
Importance: Nearly all Medicare Advantage (MA) plans offer dental, vision, and hearing benefits not covered by traditional Medicare (TM). However, little is known about MA enrollees' use of those benefits or how much they cost MA insurers or enrollees.
Objective: To estimate use, out-of-pocket (OOP) spending, and insurer payments for dental, hearing, and vision services among Medicare beneficiaries.
Challenges of sharing individual participant data for secondary research on neglected tropical diseases: the experience of Drugs for Neglected Diseases initiative and a call for action.
BMJ Open
December 2024
Drugs for Neglected Diseases initiative, Geneva, Switzerland
Introduction: The Drugs for Neglected Diseases initiative (DNDi) is committed to maximising the scientific value of the individual participant data (IPD) it has collected during its 20 years of activity and the IPD it will collect in the future, while safeguarding research participants' privacy and their right to know how their data will be processed.
Objective: The objective of this article is to share what DNDi has learnt while working on its commitment to data sharing. It also aims to advance the debate about best practice in the research community to avoid 'IPD sharing paralysis', with a focus on multistakeholder projects involving patients and researchers based in countries with various levels of data privacy regulations and measures.
Personalized Federated Learning Scheme for Autonomous Driving Based on Correlated Differential Privacy.
Sensors (Basel)
December 2024
Electrical Engineering and Computer Science (EECS), KTH Royal Institute of Technology, 10044 Stockholm, Sweden.
In the era of big data, advanced data processing devices and smart sensors greatly benefit us in many areas. As for each individual user, data sharing can be an essential part of the process of data collection and transmission. However, the issue of constant attacks on data privacy arouses huge concerns among the public.
View Article and Find Full Text PDFCommunity-based interventions against HIV-related stigma: a systematic review of evidence in Sub-Saharan Africa.
Syst Rev
January 2025
Department of Nursing and Midwifery, Faculty of Health Sciences, Mountains of the Moon University, Fort Portal, Uganda.
Background: HIV-related stigma remains a key barrier to the attainment of the UNAIDS global goal of ending AIDS by 2030. Due to the social and contextual nature of HIV-related stigma, community-based interventions may be more effective in addressing it. In this review, we synthesized evidence on the effectiveness and features of community-based interventions against HIV-related stigma in Sub-Saharan Africa.
View Article and Find Full Text PDFSustained Tl(I) removal by α-MnO: Dual role of tunnel structure incorporation and surface catalytic oxidation.
J Hazard Mater
January 2025
Key Laboratory of Eco-environments in Three Gorges Reservoir Region, Ministry of Education, College of Environment and Ecology, Chongqing University, Chongqing 400044, China.
Article Synopsis
- Manganese oxide-based filtration is an effective, cost-efficient method for removing thallium from engineered systems, although there are gaps in understanding its long-term effectiveness.
- α-MnO demonstrated a high potential for thallium removal, showing a significant increase in irreversible removal rates (81%-95%) over a 584-hour period under various conditions.
- The study reveals critical mechanisms, such as the oxidation of thallium, driven by surface Mn(III)-O interactions, highlighting how different environmental factors influence thallium binding and removal effectiveness in manganese oxide systems.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!