Health insurance co-payments deter mammo...( PROVIDENCE R.I. [Brown University] ...),Health

PROVIDENCE, R.I. [Brown University] When faced with even a modest health insurance co-payment for a mammogram, significantly fewer women receive these potentially life-saving breast cancer screenings, according to a new study by Brown University and Harvard Medical School researchers.

In this large-scale investigation of the relationship between health insurance co-payments and mammography rates, researchers found that screening rates were 8 percent lower among women with a co-payment than among women with full insurance coverage. Researchers at The Warren Alpert Medical School of Brown University, with a colleague from Harvard Medical School, publish their results in the current issue of the New England Journal of Medicine.

The message is simple and its startling a small co-payment for a mammogram can lead to a sharp decrease in breast cancer screening rates, said Amal Trivedi, M.D., lead author of the study and assistant professor in the Department of Community Health at Alpert Medical School. Co-payments as low as $12 deter women from getting mammograms. Because mammograms are critical in the fight against breast cancer, the most common cancer among American women, our findings have important health policy implications.

Eliminating co-payments for mammograms in the Medicare program has the potential to save lives, because screening detects breast cancers at an earlier, more curable stage, said John Ayanian, M.D., study co-author and professor of medicine and health care policy at Harvard Medical School and Brigham and Womens Hospital.

The effect of insurance co-payments, or consumer cost sharing, on health care use and spending is a topic of intense interest for health policy-makers and researchers. But recent long-term data on the consequences of cost sharing, like deductibles and co-pays are limited. For example, results of the RAND Health Insurance Experiment, a watershed study of cost sharing and its impact on health
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