%0 Journal Article
%T Impact of The Affordable Care Act＊s Elimination of Cost-Sharing on the Guideline-Concordant Utilization of Cancer Preventive Screenings in the United States Using Medical Expenditure Panel Survey
%J Healthcare | An Open Access Journal from MDPI
%D 2019
%R https://doi.org/10.3390/healthcare7010036
%X Currently available evidence regarding the association of the Affordable Care Act＊s (ACA) elimination of cost-sharing and the utilization of cancer screenings is mixed. We determined whether the ACA＊s zero cost-sharing policy affected the guideline-concordant utilization of cancer screenings, comparing adults (≡21 years) from 2009 with 2011每2014 data from the Medical Expenditure Panel Survey. Study participants were categorized as: 21每64 years with any private insurance, ≡65 years with Medicare only, and 21每64 years uninsured, with a separate sample for each type of screening test. Adjusted weighted prevalence and prevalence ratios (PR (95%CI)) were estimated. In 2014 (vs. 2009), privately-insured women reported 2% (0.98 (0.97每0.99)) and 4% (0.96 (0.93每0.99)) reduction in use of Pap tests and mammography, respectively. Privately-insured non-Hispanic Asian women had 16% (0.84 (0.74每0.97)) reduction in mammography in 2014 (vs. 2009). In 2011 (vs. 2009), privately-insured and Medicare-only men reported 9% (1.09 (1.03每1.16)) and 13% (1.13 (1.02每1.25)) increases in colorectal cancer (CRC) screenings, respectively. Privately-insured women reported a 6每7% rise in 2013每2014 (vs. 2009), and Hispanic Medicare beneficiaries also reported 40每44%, a significant rise in 2011每2014 (vs. 2009), in the utilization of CRC screenings. While the guideline-concordant utilization of Pap tests and mammography declined in the post-ACA period, the elimination of cost-sharing appeared to have positively affected CRC screenings of privately-insured males, females, and Hispanic Medicare-only beneficiaries. Greater awareness about the zero cost-sharing policy may help in increasing the uptake of cancer screenings. View Full-Tex
%U https://www.mdpi.com/2227-9032/7/1/36