Free Is Good, Not Great, When It Comes to Screening

November/December 2010, Vol 1, No 6 - Value Propositions

Removing payment for health insurance deductibles leads to increased, although modest, improvements in the rates of screening for conditions such as cancer and elevated cholesterol (Meeker D, et al. Health Serv Res. 2010. Online doi:10.1111/j.1475-6773.2010.01188.x). The study analyzed preventive screening use among 44,106 people enrolled in preferred provider organizations that had initiated deductible-free coverage of 4 tests—lipid screening, mammography, fecal occult blood testing, and Pap smears— which reduced but did not eliminate patient out-of-pocket costs. Screening was accessed more often when deductibles were reduced; for highdeductible plans, mammography use actually dropped.