HealthDay News — The elimination of cost sharing for screening mammography is associated with increased rates of use of the service, according to a study published in the New England Journal of Medicine.

Amal N. Trivedi, MD, MPH, from the Brown University School of Public Health in Providence, Rhode Island, and colleagues conducted a difference-in-differences study of biennial screening mammography. Data were included for 15,085 women aged 65 to 74 years in 24 Medicare Advantage plans that eliminated cost sharing and 52,035 women in 48 matched control plans that maintained full coverage.

The researchers found that the adjusted rates of biennial mammography screening increased from 59.9% to 65.4% in the 2-year periods before and after elimination of cost sharing. The rates of biennial mammography were 73.1% and 72.8% during the same periods in control plans, yielding a difference in differences of 5.7 percentage points. Among women living in the areas with the highest quartile of educational attainment vs those living in the lowest quartile, the difference in differences was 9.8 vs 4.3 percentage points. After elimination of cost sharing, the rate of biennial mammography increased by 6.5 (95% CI, 3.7 to 9.4), 8.4 (95% CI, 2.5 to 14.4), and 0.4 (95% CI, −7.3 to 8.1) percentage points for white, black, and Hispanic women, respectively.

“The elimination of cost sharing for screening mammography under the Affordable Care Act was associated with an increase in rates of use of this service among older women for whom screening is recommended,” the authors write.

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Trivedi AN, Leyva B, Lee Y, Panagiotou OA, Dahabreh IJ. Elimination of cost sharing for screening mammography in Medicare advantage plans. N Engl J Med. 2018; 378:262-269.