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Deductibles May Affect Patients' Screening Choices

Tests that are fully covered may be substituted for those that carry deductible

THURSDAY, May 8 (HealthDay News) -- Patients who have a high-deductible health insurance plan continue to have screening tests that are fully covered by their health plan but may avoid tests that are subject to their deductible, according to study findings published in the May 6 issue of the Annals of Internal Medicine.

J. Frank Wharam, of Harvard Pilgrim Health Care in Boston, and colleagues conducted a study of 3,169 members of a high-deductible health plan and 27,022 health management organization members as controls to assess uptake of mammography, Pap smears and fecal occult blood tests, all of which were fully covered in the high-deductible plan, as well as colonoscopy, flexible sigmoidoscopy and double-contrast barium enema, which were not fully covered.

Although there was no change in uptake of breast cancer and cervical cancer screening tests before and after membership in the high-deductible health plan, the researchers report, fecal occult blood testing was used more often, and colonoscopy, flexible sigmoidoscopy and double-contrast barium enema tests were used less often than in the control group.

"Given the higher sensitivity of colonoscopy versus fecal occult blood testing in detecting colorectal cancer, further study is needed regarding cancer detection and mortality among high-deductible health plan members," the authors conclude.

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