Colorectal Cancer Screening in a Nationwide High-deductible Health Plan Before and After the Affordable Care Act
Colorectal Cancer Screening in a Nationwide High-deductible Health Plan Before and After the Affordable Care Act
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DOI：
10.1097/mlr.0000000000000521
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发表时间：
2016-05-01
期刊：
影响因子：
3
通讯作者：
Ross-Degnan, Dennis
中科院分区：
文献类型：
--
作者：
Wharam, J. Frank;Zhang, Fang;Ross-Degnan, Dennis
背景：人们对《平价医疗法案》（ACA）取消预防服务自付费用的影响知之甚少。这项政策可能减少了最高免赔额的健康计划（HDHP）members.Objectives：确定ACA对结肠直肠癌筛查的影响HDHP members.Research Design：Pre-post with comparison group，constructed before and after the ACA.Subjects：我们研究了2003-2012年大型国家健康保险公司的行政索赔数据。HDHP成员在雇主强制转换后有1年的低免赔额（= 1000美元）注册; HDHP注册完全发生在ACA之后的21，605名成员和ACA之前的106，609名成员。我们倾向得分匹配同期低免赔额（
Background: Little is known about the effect of the Affordable Care Act's (ACA) elimination of out-of-pocket costs for preventive services. This policy likely reduced out-of-pocket colonoscopy costs most for high-deductible health plan (HDHP) members.Objectives: Determine the ACA's impact on colorectal cancer screening among HDHP members.Research Design: Pre-post with comparison group, constructed before and after the ACA.Subjects: We studied 2003-2012 administrative claims data of a large national health insurer. HDHP members had 1 year of low-deductible (=$ 1000) enrollment after an employer-mandated switch; HDHP enrollment occurred fully after the ACA for 21,605 members and fully before the ACA for 106,609 members. We propensity score-matched contemporaneous low-deductible (