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Member Research & Reports

Member Research & Reports

Georgia State: Endoscopy Rates Rise After Medicare Changes

Use of endoscopic colorectal cancer screenings has increased following recent changes to government-subsidized health insurance for seniors, according to a study led by a researcher from the School of Public Health at Georgia State University.

[Photo: Dr. Lee Rivers Mobley]

“This is great news,” the study stated, “because…overall utilization rates are low, and much improvement is needed in many areas of the country to encourage these recommended gold-standard [colorectal cancer] screening services.”

Previous research has shown that colonoscopies and other endoscopic screening procedures for colorectal cancer are effective in preventing precancerous tumors from developing into cancer, the study noted.

During the time of the study — 2001-2009 — a “substantial out-of-pocket co-payment was required” for endoscopic colorectal cancer screenings, the study noted. In 2006, the Medicare Prescription Drug Improvement and Modernization Act offered subsidized prescription drug packages to seniors, the savings from which researchers hypothesized would loosen budget constraints for senior patients and make endoscopy co-payments more affordable.

To measure whether endoscopy utilization rates changed after the Medicare changes, researchers analyzed endoscopy utilization data for traditional fee-for-service Medicare enrollees who remained living in the same state during two intervals: 2001-2005 and 2006 to 2009. The researchers “excluded all persons who did not have traditional FFS Medicare coverage (defined as both Parts A and B coverage for at least 11 months of the year) for all years in each interval.” They built statistical models and compared the two intervals.

“It is evident from a comparison of the two periods that average utilization increased over time and diffused or spread out over more geographic areas over time, as endoscopy became an accepted component of the gold standard for [colorectal cancer] screening,” the study stated.

The study results are published in Health Economics Review in the article “Medicare modernization and diffusion of endoscopy in FFS medicare.” The study’s lead author is Dr. Lee Rivers Mobley, associate professor of health management and policy at Georgia State University. Authors also include senior research associate Ms. Mei Zhou of the Georgia Health Policy Center at Georgia State; School of Public Health doctoral student Dr. Srimoyee Bose; Dr. Pedro Amaral with the Universidade Federal de Minas Gerais in Brazil; and Dr. Tzy-Mey Kuo with the University of North Carolina, Chapel Hill.