Study Examines Access To Timely Diagnostic Mammogram Appointments For Medicaid, Medicare Patients

Main Category: Breast Cancer
Also Included In: Medicare / Medicaid / SCHIP
Article Date: 04 Dec 2009 - 6:00 PDT

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Women with Medicaid were slightly less likely than women with Medicare coverage to secure a timely appointment for a diagnostic mammogram, though the delay "is unlikely to be a substantial barrier to mammography," according to a study published in the journal Cancer, Reuters reports. In contrast to screening mammograms, diagnostic mammograms are given to women who have had an abnormal mammogram or have symptoms suggesting they are at a high risk for breast cancer. According to the researchers, the difference in appointment times does not explain why women with Medicaid are less likely to get diagnostic mammograms, more likely to be diagnosed with late-stage breast cancer and more likely to die of the disease than women with Medicare or private insurance.

The study, led by Jeremiah Schuur of Brigham and Women's Hospital, sought to better understand whether simply having Medicaid coverage could influence a woman's care. The research team called 521 mammography facilities in 11 states to try to schedule an appointment for a diagnostic mammogram within 20 business days. The callers contacted each facility twice, once saying they had Medicaid and once saying they had Medicare. The study found that 99.1% of women who said they had Medicare were able to secure an appointment within 20 business days, compared with 91% of women who said they had Medicaid. The study found no relationship between a state's reimbursement rates and the likelihood that a woman would be able to secure an appointment within 20 business days.

It is an "open question" whether the disparity in appointment times actually affects women's health, Schuur said. He added that the research suggests that improving diagnosis and treatment of breast cancer among female Medicaid beneficiaries requires more complicated measures than solely increasing reimbursement rates. The study said that such measures could include "campaigns to raise awareness in underserved communities, patient and provider education, and outreach and case management with at-risk patients" (Harding, Reuters, 12/1).

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