Utilization of Screening Mammograms in the Medicare Population Before and After the Affordable Care Act Implementation

J Aging Health. 2020 Jan-Feb;32(1):25-32. doi: 10.1177/0898264318802047. Epub 2018 Sep 22.

Abstract

Objective: This study examined screening mammograms in women aged 65 to 74 years and 75+ years before and after the Affordable Care Act (ACA) implementation. Method: This repeated cross-sectional study of community-dwelling women age 65+ years without a history of breast cancer or mastectomy utilized the Medicare Current Beneficiary Survey and Medicare fee-for-service claims data from 2001 to 2013. We used covariate-adjusted logistic regression with generalized estimating equations, stratified by age group. Results: The adjusted odds of screening mammograms in women aged 65-74 (n = 742) and 75+ years (n = 681) were lower in 2013 (odds ratio [OR]: 0.75, 95% confidence interval [CI]: [0.67, 0.83]; OR: 0.67, 95% CI: [0.60, 0.75], respectively) than the odds of screening mammograms in 2001. Discussion: Annual screening mammograms decreased in women aged 65 to 74 years and 75+ years, despite increased access from the ACA implementation. Future research as to why women are no longer receiving screening mammograms, such as changes in physician specialty guidelines, is warranted.

Keywords: Medicare; Patient Protection and Affordable Care Act; screening mammograms; women’s health.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Advisory Committees / legislation & jurisprudence
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Guidelines as Topic
  • Humans
  • Mammography / statistics & numerical data*
  • Mammography / trends
  • Mass Screening / statistics & numerical data*
  • Mass Screening / trends
  • Medicare
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Protection and Affordable Care Act*
  • United States