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JAMA study: Medicare coverage boosts cancer, cholesterol screening for previously uninsured adults

New York City, August 12, 2003--Gaining access to Medicare coverage substantially improved uninsured older adults' use of clinical preventive measures such as cholesterol testing, mammography, and prostate exams, compared with a similar group of insured adults, according to a new study in the August 13 issue of the Journal of the American Medical Association (JAMA).

"Many older uninsured Americans have great difficulty finding affordable health insurance coverage, or even any coverage at all," said Karen Davis, president of The Commonwealth Fund, which supported the study. "An early Medicare buy-in option for these adults would ensure greater access to potentially life-saving preventive tests, which makes sense both medically and economically."

Prior to Medicare eligibility, only 41 percent of uninsured adults examined in the study received cholesterol testing, compared with 76 percent of insured adults--a difference of 35 percentage points --according to the article, "Impact of Medicare Coverage on Basic Clinical Services for Previously Uninsured Adults," by J. Michael McWilliams, M.D., Alan M. Zaslavsky, Ph.D., Ellen Meara, Ph.D., and John Z. Ayanian, M.D., of Brigham and Women's Hospital and Harvard Medical School in Boston. Meanwhile, 46 percent of uninsured adults received mammograms, versus 76 percent of insured adults (a 30 percentage point difference). For prostate cancer screening, the disparity was even greater: 29 percent of the uninsured were given this test, compared with 74 percent of the insured (a 45 percentage point difference).

Once uninsured adults became eligible for Medicare coverage, the differences in preventive testing rates between the two groups were dramatically reduced. Differences in cholesterol testing rates between previously uninsured and insured patients fell from 35 percentage points before Medicare eligibility to 18 percentage points after Medicare eligibility; differences in mammography testing rates drop
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Contact: Mary Mahon
mm@cmwf.org
212-606-3853
Commonwealth Fund
12-Aug-2003


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