ArticlePreventive medicine reports2019
The effect of the Affordable Care Act on patient out-of-pocket cost and use of preventive cancer screenings in Massachusetts.
Article in Preventive medicine reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed.
- Effect of Behavioral Economic Incentives for Colorectal Cancer Screening in a Randomized Trial.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2021Trial
- Estimating True Patient Cost-Sharing Burden: Multi-Payer Claim Reconciliation in an All-Payer Claims Database.Medical care research and review : MCRR · 2026Article
- "Is It Free?": Out-of-Pocket Costs for Annual Checkups Among the Insured.Prevention science : the official journal of the Society for Prevention Research · 2026Article
- A Retrospective Chart Analysis Comparing Breast Cancer Detection Rates Between Annual Versus Biennial Mammograms.Journal of clinical medicine research · 2024Article
- Article
- Cancer stage at diagnosis: Comparison of insurance status in SEER to the Department of Defense Cancer Registry.Cancer medicine · 2023Article
- Postpartum Medicaid coverage and outpatient care utilization among low-income birthing individuals in Oregon: impact of Medicaid expansion.Frontiers in public health · 2023Article
- Article
- Utilization and cost sharing for preventive cancer screenings.Health policy OPEN · 2021Article
- Access to Care as a Barrier to Mammography for Black Women.Policy, politics & nursing practice · 2021Article
- Evaluating statewide HIV preexposure prophylaxis implementation using All-Payer Claims Data.Annals of epidemiology · 2020Article
- Three large scale surveys highlight the complexity of cervical cancer under-screening among women 45-65years of age in the United States.Preventive medicine · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
In an effort to increase use of preventive health care, The Patient Protection and Affordable Care Act (ACA) eliminated cost-sharing for preventive cancer screening services for the privately insured. The impact on patient spending and use of these screenings is still poorly understood. We used an interrupted time series analysis with the Massachusetts All-Payer Claims Database (2009-2012) to assess changes in trends in costs and use of breast, cervical and colorectal cancer screenings after the ACA policy. We find that the ACA was associated with a 0.024 (95% CI: -0.031, -0.017, p < 0.001) and 0.424 (95% CI: -0.481, -0.368, p < 0.001) percentage point decrease in the likelihood of a copayment each week for preventive breast and cervical cancer screenings respectively. The likelihood of copayment for colon cancer screening declined throughout the study period, with the rate of decline slowing following the ACA (trend in percent of screenings with copayment -0.130 before vs -0.071 after ACA, p = 0.014). Overall, we find only weak evidence that the ACA policy increased screenings. We find no significant effect on utilization for cervical cancer or colon cancer screening. For breast cancer screening, we find a small immediate increase in the utilization rate in the month after the policy change, with no change in trend after the ACA policy. Policy makers may need to consider other complementary policy options to increase screening rates.
Identifiers
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Registered trials
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