Increase in Mammography Following Health Care Reform

Mammography screening increased following the establishment of the Medicare Shared Savings Program (MSSP), according to a study published in Radiology.

The MSSP was established as part of the Affordable Care Act (ACA), intended to improve the quality of care for Medicare Fee-For-Service beneficiaries while reducing unnecessary costs.

Researchers from Johns Hopkins Hospital in Baltimore, MD, sought to evaluate the impact of accountable care organizations (ACOs) on the use of screening mammography in the MSSP. The researchers evaluated Medicare data on women between the ages of 40 and 69 who underwent screening between 2012 and 2014. Baseline information and the ACO-20 measure (percentage of the women who underwent screening mammography within 24 months) were obtained. A total of 333 ACOs with 5,329,831 Medicare beneficiaries (mean size, 16,006 beneficiaries) participated in the MSSP.

The results showed that screening use varied across ACOs (median, 63.0%), with differences found across regions. The highest use was found in the Midwest (66.6 %) and lowest in the South (58.2%). “A total of 208 ACOs reported longitudinal outcomes, with mean change in screening mammography use of +2.6 percent (range, 233.2 percent to +42.2 percent), with 128 (61.6 percent) ACOs reporting improvements,” the researchers wrote. “No longitudinal differences in use were seen across regions, year of entry, number of beneficiaries, or total composite quality score, nor was there a difference between ACOs that saved money and those that did not.”

“Pay-for-performance incentives in ACOs can facilitate collaboration amongst various stakeholders across the healthcare continuum to improve mammography screening utilization and other key population health metrics, results which will become increasingly relevant as imaging reimbursements transition from fee-for-service to alternative or value-based payment,” study lead author Anand Narayan, MD, PhD, said in a release.

“In radiology, we can take an active role in working with other clinicians to ensure that people get appropriate preventive health services.”