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ABSTRACT: Context
Preventive care has been shown as a high-value health care service. Many employers now offer expanded coverage of preventive care to encourage utilization.Objective
To determine whether expanding coverage is an effective means to encourage utilization.Design
Comparison of screening rates before and after introduction of deductible-free coverage.Setting
People insured through large corporations between 2002 and 2006.Patients or other participants
Preferred Provider Organization (PPO) enrollees from an employer introducing deductible-free coverage, and a control group enrolled in a PPO from a second employer with no policy change.Main outcome measures
Adjusted probability of endoscopy, fecal occult blood test (FOBT), lipid screens, mammography, and Papanicolaou (pap) smears.Intervention
Introduction of first-dollar coverage (FDC) of preventive services in 2003.Results
After adjusting for demographics and secular trends, there were between 23 and 78 additional uses per 1,000 eligible patients of covered preventive screens (lipid screens, pap smears, mammograms, and FOBT), with no significant changes in the control group or in a service without FDC (endoscopy).Conclusions
FDC improves utilization modestly among healthy individuals, particularly those in lower deductible plans. Compliance with guidelines can be encouraged by lowering out-of-pocket costs, but patients' predisposing characteristics merit attention.
SUBMITTER: Meeker D
PROVIDER: S-EPMC3034268 | biostudies-literature | 2011 Feb
REPOSITORIES: biostudies-literature
Meeker Daniella D Joyce Geoffrey F GF Malkin Jesse J Teutsch Steven M SM Haddix Anne C AC Goldman Dana P DP
Health services research 20101028 1 Pt 1
<h4>Context</h4>Preventive care has been shown as a high-value health care service. Many employers now offer expanded coverage of preventive care to encourage utilization.<h4>Objective</h4>To determine whether expanding coverage is an effective means to encourage utilization.<h4>Design</h4>Comparison of screening rates before and after introduction of deductible-free coverage.<h4>Setting</h4>People insured through large corporations between 2002 and 2006.<h4>Patients or other participants</h4>Pr ...[more]