Utilization and cost sharing for preventive cancer screenings

Area of Science:

• Health Policy
• Preventive Medicine
• Cancer Screening

Background:

• The Patient Protection and Affordable Care Act (ACA) aimed to improve healthcare access and affordability.
• A key provision eliminated cost-sharing for certain preventive services, including cancer screenings, starting in September 2010.

Purpose of the Study:

• To evaluate the impact of the ACA's elimination of cost sharing on the utilization of mammography, colonoscopy, and cervical cancer screenings.
• To assess changes in preventive screening rates among commercially insured individuals following the ACA policy implementation.

Main Methods:

• A retrospective longitudinal quasi-experimental design was employed, comparing individuals in ACA-compliant plans to those in grandfathered plans (not subject to the changes).
• Propensity score matching was used to create comparable treatment and control groups.
• Interrupted time series regression analysis examined monthly screening utilization rates from 2007 to 2014.

Main Results:

• Utilization trends for preventive mammography and cervical cancer screenings showed a slight decrease after the ACA policy change.
• Colonoscopy utilization experienced a non-significant decrease during the study period.

Conclusions:

• The ACA's cost-sharing elimination policy did not achieve the intended outcome of increasing preventive cancer screening utilization.
• Further investigation into patient education regarding cost-sharing benefits at enrollment may be necessary to enhance screening uptake.