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U.S. insurance plans increasingly are incorporating cost sharing — involving cash co-payment at the time of service — into their coverage. To assess the effect cost sharing might have on use of preventive health services, investigators compared screening mammography rates from 2001 through 2004 among women (age range, 65–69) enrolled in Medicare plans requiring cost sharing versus those with full coverage for screening. The main outcome was whether or not covered women had received a screening mammogram during the previous 2 years.
The proportion of women enrolled in cost-sharing Medicare plans increased from 0.5% in 2001 to 11.4% in 2004. Overall, co-payments ranged from $12.50 to $35.00 (median, $20.00). Women enrolled in cost-sharing plan…