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

Abeer Alharbi; M Mahmud Khan; Ronnie Horner; Heather Brandt; Cole Chapman

doi:10.1186/s12889-019-6665-9

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

Journal article

Open access

Peer reviewed

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

Abeer Alharbi, M Mahmud Khan, Ronnie Horner, Heather Brandt and Cole Chapman

BMC public health, Vol.19(1), pp.370-370

04/03/2019

DOI: 10.1186/s12889-019-6665-9

PMCID: PMC6446257

PMID: 30943933

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https://doi.org/10.1186/s12889-019-6665-9View

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Abstract

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. 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. The counterfactual analysis show that the utilization of mammogram and pap test did not improve following ACA. 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.

Administrative Personnel

Cost Sharing

Female

Health Policy

Humans

Insurance Coverage

Insurance, Health

Mammography - economics

Mass Screening - economics

Medicare

Papanicolaou Test - economics

Patient Acceptance of Health Care

Patient Protection and Affordable Care Act

Preventive Health Services - economics

United States

Vaginal Smears

Details

Title: Subtitle: Impact of removing cost sharing under the affordable care act (ACA) on mammography and pap test use
Creators: Abeer Alharbi - Department of Health Services
M Mahmud Khan - University of South Carolina
Ronnie Horner - Department of Health Services
Heather Brandt - University of South Carolina
Cole Chapman - Department of Health Services
Resource Type: Journal article
Publication Details: BMC public health, Vol.19(1), pp.370-370
DOI: 10.1186/s12889-019-6665-9
PMID: 30943933
PMCID: PMC6446257
NLM abbreviation: BMC Public Health
ISSN: 1471-2458
eISSN: 1471-2458
Language: English
Date published: 04/03/2019
Academic Unit: Pharmacy Practice and Science
Record Identifier: 9984366035702771

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