May 1, 2012

Two-year trends in cancer screening among low socioeconomic status women in an HMO-based high-deductible health plan

Journal of General Internal Medicine
J Frank WharamBruce E Landon

Abstract

Cancer screening is often fully covered under high-deductible health plans (HDHP), but low socioeconomic status (SES) women still might forego testing. To determine the impact of switching to a HDHP on breast and cervical cancer screening among women of low SES. Pre-post with comparison group. Four thousand one hundred and eighty-eight health plan members enrolled for one year before and up to two years after an employer-mandated switch from a traditional HMO to an HMO-based HDHP, compared with 9418 propensity score matched controls who remained in HMOs by employer choice. Both groups had low outpatient copayments. High-deductible members had full coverage of mammography and Pap smears, but $500 to $2000 individual deductibles for most other services. HMO members had full coverage of cancer screening and low copayments for other services without any deductible. We stratified analyses by SES. Transition to a HDHP. Annual breast and cervical cancer screening rates; rates of annual preventive outpatient visits. In follow-up years 1 and 2, low SES HDHP members experienced no statistically detectable changes in rates of breast cancer screening (ratio of change, 1.14, 95 % CI, [0.93,1.40] and 1.05, [0.80,1.37], respectively) or preve...Continue Reading

  • References30
  • Citations7

Citations

Mentioned in this Paper

Health Maintenance Organizations
Incidence Studies
Mammography, Female
Screening for Cancer
Outpatients
Uterine Cervical Neoplasm
Pap Smear
Socioeconomic Status
Selenium Deficiency
Mammary Neoplasms

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