The impact of medicaid coverage and reimbursement on access to diagnostic mammography

Cancer

Volumn 115, Issue 23, 2009, Pages 5566-5578

  Schuur, Jeremiah D ^a,b,c,d   Shah, Akash ^b   Wu, Zheyang ^b   Forman, Howard P ^b,e   Gross, Cary P ^b,f  

^a VA CONNECTICUT HEALTHCARE SYSTEM   (United States)

^b YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

^c BRIGHAM AND WOMEN S HOSPITAL   (United States)

^d HARVARD MEDICAL SCHOOL   (United States)

^e YALE SCHOOL OF MANAGEMENT   (United States)

^f YALE CANCER CENTER   (United States)

Author keywords

Access to healthcare; Health insurance reimbursement; Health policy; Mammography; Medicaid; Medicare

Indexed keywords

ADULT; ARTICLE; BREAST CANCER; CANCER PATIENT; DIAGNOSTIC IMAGING; FEMALE; HEALTH CARE ACCESS; HEALTH CARE FACILITY; HEALTH CARE POLICY; HEALTH INSURANCE; HUMAN; MAMMOGRAPHY; MEDICAID; MEDICARE; PRIORITY JOURNAL; REIMBURSEMENT;

APPOINTMENTS AND SCHEDULES; FEMALE; HEALTH SERVICES ACCESSIBILITY; HUMANS; INSURANCE COVERAGE; INSURANCE, HEALTH, REIMBURSEMENT; MAMMOGRAPHY; MEDICAID; MEDICARE; TIME FACTORS; UNITED STATES;

EID: 72249103420     PISSN: 0008543X     EISSN: 10970142     Source Type: Journal    
DOI: 10.1002/cncr.24637     Document Type: Article

References (57)

1. Michaelson JS, Satija S, Kopans D, et al. Gauging the impact of breast carcinoma screening in terms of tumor size and death rate. Cancer. 2003;98:2114-2124. (Pubitemid 37392414)
2. Smith RA, Cokkinides V, Eyre HJ; American Cancer Society. American Cancer Society guidelines for the early detection of cancer, 2004. CA Cancer J Clin. 2004;54:41-52. (Pubitemid 38443419)
3. US Preventative Services Task Force. Screening for Breast Cancer: Recommendations and Rationale. 2006. Available at: http://www.ahrq.gov/clinic/ 3rduspstf/breastcancer Accessed March 30, 2006.
4. Vainio H, Bianchini F, eds; International Agency for Research on Cancer (IARC) Handbooks of Cancer Prevention. Vol.7: Breast Cancer Screening. Lyon, France: IARC Press; 2002.
5. Barton MB, Morley DS, Moore S, et al. Decreasing women's anxieties after abnormal mammograms: a controlled trial. J Natl Cancer Inst. 2004;96:529-538. (Pubitemid 38559577)
6. Richards MA, Westcombe AM, Love SB, Littlejohns P, Ramirez AJ. Influence of delay on survival in patients with breast cancer: a systematic review. Lancet. 1999;353:1119-1126. (Pubitemid 29155203)
7. Barr JK, Franks AL, Lee NC, Herther P, Schachter M. Factors associated with continued participation in mammography screening. Prev Med. 2001;33:661-667. (Pubitemid 34101892)
8. DuBard CA, Schmid D, Yow A, Rogers AB, Lawrence WW. Recommendation for and receipt of cancer screenings among Medicaid recipients 50 years and older. Arch Intern Med. 2008;168:2014-2021.
9. [No authors listed] StatBite: percentage screened for cancer by insurance status [serial online]. J Natl Cancer Inst. 2008;100:772.
10. Chang SW, Kerlikowske K, Napoles-Springer A, Posner SF, Sickles EA, Perez-Stable EJ. Racial differences in timeliness of follow-up after abnormal screening mammography. Cancer. 1996;78:1395-1402. (Pubitemid 26317859)
11. Elmore JG, Nakano CY, Linden HM, Reisch LM, Ayanian JZ, Larson EB. Racial inequities in the timing of breast cancer detection, diagnosis, and initiation of treatment. Med Care. 2005;43:141-148. (Pubitemid 40222632)
12. Caplan LS, May DS, Richardson LC. Time to diagnosis and treatment of breast cancer: results from the National Breast and Cervical Cancer Early Detection Program, 1991-1995. Am J Public Health. 2000;90:130-134.
13. Jones BA, Dailey A, Calvocoressi L. Inadequate follow-up of abnormal screening mammograms: findings from the race differences in screening mammography process study (United States). Cancer Causes Control. 2005;16:809-821. (Pubitemid 41166546)
14. Press R, Carrasquillo O, Sciacca RR, Giardina EG. Racial/ ethnic disparities in time to follow-up after an abnormal mammogram. J Womens Health. 2008;17:923-930.
15. Roetzheim RG, Pal N, Tennant C, et al. Effects of health insurance and race on early detection of cancer. J Natl Cancer Inst. 1999;91:1409-1415. (Pubitemid 29400000)
16. Bradley CJ, Given CW, Roberts C. Late stage cancers in a Medicaid-insured population. Med Care. 2003;41:722-728.
17. Halpern MT, Bian J, Ward EM, Schrag NM, Chen AY. Insurance status and stage of cancer at diagnosis among women with breast cancer. Cancer. 2007;110:403-411. (Pubitemid 47121902)
18. Ayanian JZ, Kohler BA, Abe T, Epstein AM. The relation between health insurance coverage and clinical outcomes among women with breast cancer. N Engl J Med. 1993;329:326-331. (Pubitemid 23210686)
19. Bradley CJ, Gardiner J, Given CW, Roberts C. Cancer, Medicaid enrollment, and survival disparities. Cancer. 2005;103:1712-1718.
20. Harlan LC, Greene AL, Clegg LX, Mooney M, Stevens JL, Brown ML. Insurance status and the use of guideline therapy in the treatment of selected cancers. J Clin Oncol. 2005;23:9079-9088. (Pubitemid 46260163)
21. Ward E, Jemal A, Cokkinides V, et al. Cancer disparities by race/ethnicity and socioeconomic status. CA Cancer J Clin. 2004;54:78-93. (Pubitemid 38519418)
22. Office of Program Policy Analysis and Government Accountability. Access to Mammography Services in Florida Is More Limited for Low-Income Women. Tallahassee, Fla: Office of Program Policy Analysis and Government Accountability; 2004.
23. General Accounting Office. Mammography: Current Nationwide Capacity Is Adequate, but Access Problems May Exist in Certain Locations. Washington, DC: General Accounting Office; 2006.
24. Gotbaum B, Tumarkin L, Han SA, Isenstadt M, Shekhter L. Missing the Mark: HHC Mammogram Wait Time Off Target. New York, NY: Public Advocate for the City of New York; 2006.
25. Meyeroff W. A look ahead: experts offer advice on making Medicare reimbursements work for medical imagers. Med Imag. 2005. Available at: http://www.imagingeconomics. com/issues/articles/MI-2005-01-03.asp Accessed on May 1, 2009.
26. Nass S, Ball J. Improving Breast Imaging Quality Standards. Washington, DC: Institute of Medicine and National Research Council; 2005.
27. Institute of Medicine National Cancer Policy Board and Global Affairs Board on Science, Technology, and Economic Policy; Committee on New Approaches to Early Detection and Diagnosis of Breast Cancer. Increased Access to High- Quality Mammography Needed to Reduce Cancer Deaths; Shortage of Screening Specialists Should Be Addressed to Deal With Capacity Crisis. Bethesda, Md: Institute of Medicine; 2004. Available at: http://www.nationalacademies. org/onpinews/newsitem.aspx?RecordID=11016 Accessed November 1, 2008.
28. Skaggs DL, Clemens SM, Vitale MG, Femino JD, Kay RM. Access to orthopedic care for children with Medicaid versus private insurance in California [serial online]. Pediatrics. 2001;107:1405-1408.
29. Wang EC, Choe MC, Meara JG, Joempel JA. Inequality of access to surgical specialty health care: why children with government-funded insurance have less access than those with private insurance in Southern California [serial online]. Pediatrics. 2004;114:e584-e590.
30. Resneck JJ, Pletcher MJ, Lozano N. Medicare, Medicaid, and access to dermatologists: the effect of patient insurance on appointment access and wait times. J Am Acad Dermatol. 2004;50:85-92. (Pubitemid 38095657)
31. Asplin BR, Rhodes KV, Levy H, et al. Insurance status and access to urgent ambulatory care follow-up appointments. JAMA. 2005;294:1248-1254. (Pubitemid 41352113)
32. Galbraith AA, Grossman DC, Koepsell TD, Heagerty PJ Christakis DA. Medicaid acceptance and availability of timely follow-up for newborns with Medicaid. Pediatrics. 2005;116:1148-1154.
33. Isaacs SL, Knickmann JR, eds. The Dartmouth Atlas of Health Care. Princeton, NJ: The Robert Wood Johnson Foundation; 2006. Available at: http://www.dartmouthatlas. org Accessed October 1, 2005.
34. Centers for Medicare and Medicaid Services (CMS). Medicare Physician Fee Schedule Look-Up. Available at: http://www.cms.hhs.gov/PFSLookup Accessed November 1, 2008.
35. Zuckerman S, McFeeters J, Cunningham P, Nichols L. Trends: changes in Medicaid physician fees, 1998-2003: implications for physician participation [serial online]. Health Aff (Millwood). 2004;W4(suppl web exclusives):374-384.
36. D'Orsi C, Tu S-P, Nakano C, et al. Current realities of delivering mammography services in the community: do challenges with staffing and scheduling exist? Radiology. 2005;235:391-395.
37. US Food and Drug Administration. FDA Listing of Mammography Quality and Safety Act-Certified Mammography Facilities. Washington, DC: US Food and Drug Administration; 2006.
38. Jones W, Elwyn G, Edwards P, Edwards A, Emmerson M, Hibbs R. Measuring access to primary care appointments: a review of methods [serial online]. BMC Fam Pract. 2003;4:8.
39. Fisher RJ. Social desirability bias and the validity of indirect questioning. J Consum Res. 1993;20:303-315.
40. [No authors listed] High-quality mammography: information for referring providers. Clin Pract Guide Quick Ref Guide Clin. 1994;13:1-18.
41. Institute for Healthcare Improvement. Third Next Available Appointment. IHI website. Available at: http://www.ihi.org/ IHI/Topics/OfficePractices/ Access/Measures/Third+Next+ Available+Appointment.htm Accessed March 30, 2009.
42. Bryk AS, Raudenbush SW. Hierarchical Linear Models. 2nd ed. London, United Kingdom: Sage; 2002.
43. The Henry J. Kaiser Family Foundation. State Health Facts. Available at: http://www.statehealthfacts.org Accessed August 1, 2006.
44. Rabe-Hesketh S, Skrondal A, Pickles A. GLLAMM Manual. University of California Berkeley Division of Biostatistics Working Paper Series. Berkeley, Calif: University of California at Berkeley; 2004: 33-39.
45. Borgstede JP. The worthiest of causes. Am Coll Radiol Bull. 2006;61:1.
46. Farria DM, Schmidt ME, Monsees BS, et al. Professional and economic factors affecting access to mammography: a crisis today, or tomorrow? Cancer. 2005;104: 491-498.
47. Office of US Senator Charles Schumer. Press Release, February 18, 2001. Schumer: lack of access to mammograms puts thousands of New York City and Long Island women at risk. Available at: http://schumer.senate.gov/1- Senator%20Schumer%20Website%20Files/pressroom/press- releases/PR00494.html Accessed March 30, 2006.
48. Earp JA, Eng E, O'Malley MS, et al. Increasing use of mammography among older, rural African American women: results from a community trial. Am J Public Health. 2002;92:646-654. Medicaid Reimbursement and Mammography/Schuur et al Cancer December 1, 2009 5577
49. Dietrich AJ, Tobin JN, Cassells A, et al. Telephone care management to improve cancer screening among lowincome women: a randomized, controlled trial. Ann Intern Med. 2006;144:563-571. (Pubitemid 46768145)
50. Roetzheim RG, Christman LK, Jacobsen PB, et al. A randomized controlled trial to increase cancer screening among attendees of community health centers. Ann Fam Med. 2004;2:294-300. (Pubitemid 39107884)
51. Ell K, Vourlekis B, Lee P-J, Xie B. Patient navigation and case management following an abnormal mammogram: a randomized clinical trial. Prev Med. 2007;44:26-33. (Pubitemid 46073077)
52. Perloff JD, Kletke P, Fossett JW. Which physicians limit their Medicaid participation, and why. Health Serv Res. 1995;30:7-26.
53. Cunningham PJ, Nichols LM. The effects of Medicaid reimbursement on the access to care of Medicaid enrollees: a community perspective. Med Care Res Rev. 2005;62:676-696.
54. Santerre RE. The inequity of Medicaid reimbursement in the United States. Appl Health Econ Health Policy. 2002; 1:25-32.
55. May DS, Lee NC, Nadel MR, Henson RM, Miller DS. The National Breast and Cervical Cancer Early Detection Program: report on the first 4 years of mammography provided to medically underserved women. AJR Am J Roentgenol. 1998;170:97-104.
56. Centers for Medicare and Medicaid Services (CMS). Medicaid website. Available at: http://www.cms.hhs.gov/ MedicaidEligibility/03- MandatoryEligibilityGroups Accessed August 1, 2006.
57. Freeman HP, Reuben SH. Voices of a broken system. Real problems, real people. In: President's Cancer Panel, Report of the Chairman, 2000-2001. Bethesda, Md: National Cancer Program, National Cancer Institute; 2001.