The researchers sought to examine how coverage mandates impacted the use and price of DBT, so they compared the numbers between states where insurers are required to cover the exam as part of mammographic screenings to those without the same or similar legislation. This analysis included more than 9 million screening mammograms completed on over 5 million women between January 1, 2015, and June 30, 2019.
During this time, 15 states had mandated coverage while 34 did not. Compared to the states without DBT legislation, the states with coverage mandates saw an increase in DBT use by 9 percentage points during the first two years after the laws were put into place. The mandates also resulted in a drop in overall DBT price of around $38. There were no changes in out-of-pocket payments, which the experts discovered were rare for the exam, for mandated or nonmandated states despite DBT’s increased use.
“A central policy objective of coverage mandates is to ensure access to a particular medical technology or service by protecting patients from financial liability,” the authors said. “These findings suggest that out-of-pocket payments were rare regardless of whether a mandate was in place and likely were not the primary barrier to DBT use for most women. Instead, our findings raise the possibility that DBT coverage mandates contributed to broader adoption of DBT among radiologists, perhaps by reducing uncertainty about payment.”
The detailed study can be viewed on JAMA Network Open.
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The impact of state-level digital breast tomosynthesis coverage mandates - Health Imaging
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