Assessing mammography rates for Medicaid recipients age 50 to 65 years using claims data from a southeastern state

A retrospective Medicaid claims data analysis for physician-submitted mammography procedure codes was performed for all continuously eligible female Louisiana Medicaid recipients in 1994. The study measured mammography screening and diagnostic radiology procedures, using CPT coding logic. The study population consisted of 19,688 female Medicaid recipients, age 50 to 65, comprising 55% of the total female Medicaid recipients within Louisiana. In this cohort, 18.3% received a mammogram, with approximately 50% being diagnostic mammography procedures. No significant racial difference in utilization of mammography was found for this population. This claims data analysis suggests that Louisiana's Medicaid population appears to be underserved with respect to mammography screening. The authors conclude that community, physician, and public health resources would be well served to place more emphasis on educational and other outreach programs. Louisiana has to increase its rates for Medicaid recipients by 50% to meet the goal of screening 60% of eligible women every 2 years as set forth in Healthy people 2000, by the United States Public Health Service.