Reprinted Articles

Some seniors on fixed incomes are opting out of lifesaving screenings in an effort to save money on the co-pays. This fact comes from an alarming study out of Brown University that was published in the New England Journal of Medicine. The study revealed that mammography rates dropped by 8% with women with women who were required to provide a co-pay as opposed to those with full coverage.

Amal Trivedi, M.D., the researcher and lead author in the study found the findings “simple and startling - a small co-payment for a mammogram can lead to a sharp decrease in breast cancer screening rates.” He goes on to say that “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.”

John Ayanian, M.D., a co-author on the study suggests that if Medicare eliminated the co-payments for mammograms that it could potentially save lives. Early detection is critical in the prevention and cure of breast cancer.

The study has important implications in regards to health policy making. The results revealed that screening rates dropped 5.5 percent with insurance plans that required co-pays but increased by 3.4% with plans that had full coverage.

The study detailed mammography data from 174 Medicare insurance programs. They looked at statistics from 336,475 women between the ages of 65 and 69 from 2001-2004. Some of the data revealed that

* Breast cancer screening rates were 8-11% lower in groups that had co-payment plans. The difference existed even when there were adjustments made for income, education, race, etc.

* From 2002-2004, breast cancer screening rates decreased by 6% in plans that included co-payment plans. Conversely, breast cancer screening rates increased in plans that continued their full coverage program.

* The rate of plans that required co-pays for breast cancer screening grew from 3 plans for 21 plans within the range of 3 years (2001-2004). The increase in these insurance plans with this cost-sharing feature affected .5 % of women in 2001 and then increased to 11% of women in 2004.

* The range of price in co-payments in the insurance plans with cost sharing programs ranged from $12.50-$35. The average cost was approximately $20.

All of the doctors and researchers in the study strongly recommended that insurance companies eliminate the cost sharing programs in some of the preventive screening procedures, especially mammograms. The benefits of saving lives were far greater than the benefit of the cost savings to the insurance companies.

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