Removing Deductible Affects Use of Preventive Screenings

PPO change to first-dollar coverage linked to modest increase in screening
By Eric Metcalf
HealthDay Reporter

THURSDAY, Oct. 28 (HealthDay News) -- Among healthy individuals, the use of first-dollar coverage -- also known as zero-deductible coverage -- may modestly improve utilization of preventive services, especially in people in low-deductible plans, according to research published online Oct. 28 in Health Services Research.

Daniella Meeker, Ph.D., of the RAND Corporation in Santa Monica, Calif., and colleagues analyzed data from enrollees in a preferred provider organization (PPO) from an employer that introduced deductible-free coverage and controls enrolled in a PPO from another employer that had no deductible policy change.

Among plans that introduced first-dollar coverage, the researchers found 23 to 78 additional uses per 1,000 eligible patients for services that were covered, which were lipid screens, Pap smears, mammograms, and fecal occult blood testing. No significant changes were seen in the control group or in endoscopy, which was not covered by the first-dollar coverage policy.

"Our study suggests that reducing cost-sharing for preventive services encourages screening among PPO enrollees, across several categories, but this effect is significantly attenuated among individuals that opt for high-deductible plans. Other techniques, such as patient and physician reminders and patient and physician education, have showed at least modest success in some populations. Future research should investigate the efficacy of such approaches with respect to people that select high-deductible plans," the authors write.

The study was sponsored in part by Merck Inc.

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