ArticlePreventive medicine2015
Has recommended preventive service use increased after elimination of cost-sharing as part of the Affordable Care Act in the United States?
Article in Preventive medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 85 citations in OpenAlex.
- Impact of the Affordable Care Act on Colorectal Cancer Outcomes: A Systematic Review.American journal of preventive medicine · 2020Pooled it
- Review
- Trends and disparities in bone cancer mortality among US adults from 1999 to 2020: a joinpoint regression analysis based on the CDC WONDER database.Frontiers in oncology · 2026Article
- Socio-economic and insurance factors in preventive care: A two-stage weighted structural analysis.Dialogues in health · 2025Article
- Zero-shot learning to extract assessment criteria and medical services from the preventive healthcare guidelines using large language models.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Patient Cost-Sharing and Utilization of Breast Cancer Diagnostic Imaging by Patients Undergoing Subsequent Testing After a Screening Mammogram.JAMA network open · 2023Article
- Preventive care use among Hispanic adults with limited comfort speaking English: An analysis of the Medical Expenditure Panel Survey data.Preventive medicine · 2022Article
- Utilization and cost sharing for preventive cancer screenings.Health policy OPEN · 2021Article
- Social Determinants of Health Associated with the Use of Screenings for Hypertension, Hypercholesterolemia, and Hyperglycemia among American Adults.Medical sciences (Basel, Switzerland) · 2021Article
- Preventing Breast, Cervical, and Colorectal Cancer Deaths: Assessing the Impact of Increased Screening.Preventing chronic disease · 2020Article
- Use of cervical cancer preventive services among US women aged 21-29: an assessment of the 2010 Affordable Care Act rollout through 2018.Cancer causes & control : CCC · 2020Article
- Utilization and Cost of Mammography Screening Among Commercially Insured Women 50 to 64 Years of Age in the United States, 2012-2016.Journal of women's health (2002) · 2020Article
- Effects of the Affordable Care Act on the Receipt of Colonoscopies among the Insured Elderly.International journal of environmental research and public health · 2020Article
- How Do Accountable Care Organizations Deliver Preventive Care Services? A Mixed-Methods Study.Journal of general internal medicine · 2019Article
- The effect of the Affordable Care Act on patient out-of-pocket cost and use of preventive cancer screenings in Massachusetts.Preventive medicine reports · 2019Article
- Breast, Cervical, and Colorectal Cancer Screening: Patterns Among Women With Medicaid and Commercial Insurance.American journal of preventive medicine · 2019Article
- Cervical and colorectal cancer screening prevalence before and after Affordable Care Act Medicaid expansion.Preventive medicine · 2019Article
- Prevalence of Out-Of-Pocket Payments for Mammography Screening Among Recently Screened Women.Journal of women's health (2002) · 2019Article
- Adapting to a Shifting Health Care Landscape: Illinois Breast and Cervical Cancer Program Lead Agencies' Perspectives.Health promotion practice · 2019Article
- Impact of removing cost sharing under the affordable care act (ACA) on mammography and pap test use.BMC public health · 2019Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAn early provision of the Affordable Care Act (ACA) eliminated cost-sharing for a range of recommended preventive services. This provision took effect in September 2010, but little is known about its effect on preventive service use.
methodsWe evaluated changes in the use of recommended preventive services from 2009 (before the implementation of ACA cost-sharing provision) to 2011/2012 (after the implementation) in the Medical Expenditure Panel Survey, a nationally representative household interview survey in the US. Specifically, we examined: blood pressure check, cholesterol check, flu vaccination, and cervical, breast, and colorectal cancer screening, controlling for demographic characteristics and stratifying by insurance type.
resultsThere were 64,280 (21,310 before and 42,970 after the implementation of ACA cost-sharing provision) adults included in the analyses. Receipt of recent blood pressure check, cholesterol check and flu vaccination increased significantly from 2009 to 2011/2012, primarily in the privately insured population aged 18-64years, with adjusted prevalence ratios (95% confidence intervals) 1.03 (1.01-1.05) for blood pressure check, 1.13 (1.09-1.18) for cholesterol check and 1.04 (1.00-1.08) for flu vaccination (all p-values<0.05). However, few changes were observed for cancer screening. We observed little change in the uninsured population.
conclusionsThese early observations suggest positive benefits from the ACA policy of eliminating cost-sharing for some preventive services. Future research is warranted to monitor and evaluate longer term effects of the ACA on access to care and health outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.