Medicaid reimbursement impacts Pap, mammography screening

An analysis of data from 46 states and the District of Columbia shows that the level of Medicaid reimbursement for office visits has an impact on likelihood of patient screening with Pap tests and other diagnostics for cancer. The results, published in Cancer, suggests that such reimbursements may be an important policy tool for increasing screening in a vulnerable population.

Led by researchers from RTI International, the cross-sectional analysis involved 2007 Medicaid data and looked at associations between state-specific Medicaid reimbursement/eligibility policies and receipt of cancer screening. Individuals ages 21 to 64 who were enrolled in fee-for-service Medicaid for at least 4 months were included. Among this population, more than 2 million patients were eligible for Pap tests, nearly 800,000 for mammography, more than 760,000 for colonoscopy, and more than 750,000 for fecal occult blood testing. Among state-specific Medicaid variable were median screening test reimbursement, income/financial asset eligibility requirements, physician copayments, and frequency of eligibility renewal.

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Both positive and negative associations were found between increase reimbursement for screening tests and likelihood of Medicaid beneficiaries receiving the tests. A positive association was found between increased reimbursement for office visits and odds of receiving all screening tests, including Pap test (odds ratio [OR], 1.02; 95% CI, 1.02-1.03), mammography (OR, 1.02; 95% CI, 1.02-1.03), colonoscopy (OR 1.07; 95% CI, 1.06-1.08) and fecal occult blood testing (OR, 1.09; 95% CI, 1.08-1.10). Effects of other state-specific Medicaid policies varies across the screening tests examined. 

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