HCP professor John Z. Ayanian, MD, MPP, and colleagues studied mammography rates within 174 Medicare health plans, comparing plans in which mammograms were subject to a copayment and those in which the patient bore no cost for the procedure. The researchers found that even relatively small copayments (as low as $12) resulted in significantly lower rates of screening mammography than in plans that fully cover the service. This effect was especially pronounced for women living in poorer or less-educated communities. The authors suggest that, for improving health as well as for economic reasons, important preventive services such as mammography be exempt from copayments.

The study was published in the New England Journal of Medicine; the first author, Amal N. Trivedi, MD, MPH, of Brown University, is a former HCP postdoctoral fellow. The study was widely covered by media outlets, including the New York Times, Reuters, webMD, and msn.com.