Navigation Links
Co-Pays Contribute to Drop in Preventive Care
Date:1/23/2008

Even small co-pays made some women opt out of screening mammographies, study finds,,,,

WEDNESDAY, Jan. 23 (HealthDay News) -- A co-pay as small as $10 can stand in the way of a woman getting a potentially lifesaving mammography, new research suggests.

When women in Medicare managed-care plans were asked to contribute a small co-pay, in some cases around $10 to $20, 8 percent of the women decided to forgo mammograms altogether, according to a study published in the Jan. 24 issue of the New England Journal of Medicine.

"A small co-pay can lead to a sharp decrease in the breast cancer screening rate," said study author Dr. Amal Trivedi, an assistant professor of community health at the Warren Alpert School of Medicine at Brown University in Providence, R.I.

Trivedi said more and more, insurance plans are instituting cost-sharing in the form of co-pays, and the idea behind it is to get consumers to consider cost before getting health-care services. The hope is that people will reconsider potentially unnecessary procedures or medicines but not forgo essential health-care services. However, it doesn't always work out that way, as this study illustrates.

"This is an example where a co-pay had an adverse effect on health," Trivedi said. "For highly valuable services, such as mammography, insurers should eliminate co-pays. It could save lives. And, a small co-pay doesn't make a lot of economic sense if it deters women from getting timely screenings. The costs of untreated early disease are much higher."

Trivedi and his colleagues reviewed mammography data from 174 Medicare managed-care insurance programs. They reviewed data on 366,475 women between the ages of 65 and 69 from 2001 through 2004.

The researchers compared plans with cost-sharing to those that didn't. They also compared rates of mammography in plans with recently instituted co-pays to those that retained full coverage.

The number of insurance plans that required a $10 co-pay or more, or a 10 percent or higher co-insurance payment per mammography, increased dramatically during the study period, according to Trivedi.

"In 2001, one woman in 200 was required to pay a co-pay. In 2004, the number required to pay a co-pay had increased to one in nine. That's a twenty=fold increase," he said.

Those co-pays made a difference in care. Screening rates were 8.3 percent lower in the cost-sharing plans versus plans with full coverage. Cost-sharing appeared to hit the poorest and least educated women the hardest.

Screening rates dropped 5.5 percent in insurance plans that introduced cost-sharing during the study period, yet increased by 3.4 percentage points in plans that maintained full coverage.

"A proportion of the population is very price-sensitive, and they tend to be the ones with fewer dollars to start. Apparently, we haven't been able to make our case to this group of women that $10 spent on mammography is money well-spent," said Dr. Peter Bach, a pulmonologist and epidemiologist at Memorial Sloan-Kettering Cancer Center in New York City.

Bach, who wrote an accompanying editorial in the same issue of the journal and was a senior advisor for Medicaid and Medicare Services, said this study shouldn't be interpreted to mean that all co-pays should be waived for preventive services. "We have to ask, what's the health gain? It doesn't matter the cost per test. Some preventive services really work, and some don't. We want people to use services that are of value."

Because "the value of breast cancer screening has been demonstrated in many studies," Trivedi said he does recommend waiving co-pays for mammograms. "Co-pays can deter women from getting mammograms. I would urge health plans to eliminate co-pays."

More information

To learn more about screening mammography, visit the National Women's Health Information Center.



SOURCES: Amal Trivedi, M.D., assistant professor, community health, Warren Alpert School of Medicine, Brown University, Providence, R.I.; Peter Bach, M.D., pulmonologist and epidemiologist, Memorial Sloan-Kettering Cancer Center, New York City; Jan. 24, 2008, New England Journal of Medicine


'/>"/>
Copyright©2008 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Lowering Co-Pays on Some Drugs Help Fight Chronic Diseases
2. High Co-Pays Cause Seniors to Go Without Meds
3. Pharmacists believe drive-through windows contribute to delays, errors
4. TriWest Contributes $15,000 to North Dakota National Guard Fund
5. TriWest Contributes $12,000 to Alaska National Guard Fund
6. Early surgical treatment contributes to better outcomes in gallstone pancreatitis cases
7. TriWest Contributes $15,000 to Kansas National Guard Fund
8. TriWest Contributes $15,000 to New Mexico National Guard Fund
9. TriWest Contributes $75,000 to Agencies Supporting California Guardsmen
10. TriWest Contributes $15,000 to Support Idaho National Guard Families
11. TriWest Contributes $25,000 to Washington National Guard Fund and Sponsors Education for Teachers of Military Children
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/26/2016)... ... May 26, 2016 , ... Connor Sports, through its Connor ... for the Tamika Catchings Legacy Tour that will commemorate the Indiana Fever ... basketball surfaces in all forms and levels of the game, Connor Sports has committed ...
(Date:5/26/2016)... , ... May 26, 2016 , ... The Woodlands ... offering a new model of care for living and healing, celebrated its grand ... Meaningful Life in a Real Home provided by Empowered Staff. , “This is an ...
(Date:5/26/2016)... ... ... There are nearly 14.5 million people living with and beyond cancer in the ... 2016, communities around the world will gather to recognize these cancer survivors as part ... is an annual worldwide Celebration of Life that is held on the first Sunday ...
(Date:5/26/2016)... ... May 26, 2016 , ... Catalent Pharma Solutions, the leading ... health and global clinical supply services, today announced two key appointments and the ... investment and strategic growth plans in the Asia Pacific region. , Howard Kim ...
(Date:5/26/2016)... ... May 26, 2016 , ... An April Gallup survey ... , The 550 employees of Sun Health Senior Living (SHSL) may not ... reduces their doctor and prescription copays for the year, while holding the line on ...
Breaking Medicine News(10 mins):
(Date:5/25/2016)... -- According to market research "Global Insulin ... Forecast to 2022 - Industry Insights by Type (Insulin ... P&S Market Research, the global insulin delivery device market ... is expected to grow at a CAGR of 6.6% ... is expected to witness the fastest growth at a ...
(Date:5/25/2016)... England , May 25, 2016 ... company employing the precision of circulating tumour DNA ... today announces the appointment of Professor Clive ... provide medical leadership across the clinical development programme, ... Inivata,s products help deliver significant improvements in clinical ...
(Date:5/24/2016)... 24, 2016   , ... in overall bowel cleansing and superiority in ... leansing of the ascending ... , Norgine B.V. today announced new positive data from ... ascorbate bowel preparation) versus standard 2 litre PEG with ascorbate. The ...
Breaking Medicine Technology: