Co-pays hinder preventive mammography care

As more and more patients are asked to shoulder the cost of their health care, are they willing to shell out the funds to pay for important preventive care such as mammography? That's the question researchers from Boston sought to answer.

In a study published in the New England Journal of Medicine (1/24/2008), the researchers looked at women between the ages of 65 and 69 and compared the rates of biennial breast-cancer screening for those enrolled in Medicare plans that provided full coverage versus the rates for those enrolled in plans requiring co-payments. Their analysis found that the rates of screening were 77.5% in plans with full coverage and 69.2% in plans with cost-sharing. Additionally, the rate of screening for women in plans with cost-sharing was 7.2 percentage points lower than the rate for women in plans offering full coverage.

To explain why co-payments would discourage patients from taking advantage of preventive care like mammography, the researchers cite a couple of reasons. First, adults 65 and older may have increased out-of-pocket health-care expenses associated with chronic medical conditions; so, making even a small co-payment could be a significant financial burden. Second, patients may view preventive care as less important-and therefore, less worthy of funding-than care for symptomatic conditions.