THE EFFECT OF MEDICINE REIMBURSEMENT FOR SCREENING MAMMOGRAPHY ON UTILIZATION AND PAYMENT

Objective. In January 1991, Medicare extended its mammography benefit to reimburse for breast cancer screening mammograms. in 1991 and again in 1993, the National Cancer institute Breast Cancer Screening Consor tium (BCSC) conducted a survey to test the hypothesis that this benefi t would increase mammography use among women over the age of 65. Metho ds. The authors analyzed data on non-Hispanic white women ages 65 to 7 4 living in 11 geographic areas targeted by the BCSC for an earlier st udy-six that had received cancer screening educational interventions a nd five control subsites-to measure the impact of the newly adopted Me dicare benefit on the use of mammography and use of Medicare to reimbu rse mammography costs. Results. The data show little overall increase between 1991 and 1993 in reported mammography use among respondents to the survey. However, in six intervention and five control subsites th ere was an increase in the percentage of women who reported using publ ic payment sources to at least partially reimburse the cost of mammogr ams. In three intervention subsites, the increase from 1991 to 1993 in the percentage of women using public sources of payment was greater t han in the corresponding control subsites. Conclusions. These findings suggest that public health interventions are more likely to succeed w hen educational promotion accompanies a financial benefit.