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Removing Out-of-Pocket Fee Boosts Rates of Digital Breast Mammography

By Lori Solomon HealthDay Reporter

Medically reviewed by Carmen Pope, BPharm. Last updated on July 9, 2025.

via HealthDay

WEDNESDAY, July 9, 2025 -- Removing a modest out-of-pocket fee significantly improves access to digital breast tomosynthesis (DBT; 3D mammography), particularly among underserved patients, according to a study published online June 19 in the Journal of the American College of Radiology.

Nina Capiro, M.D., from the University of California, Los Angeles, and colleagues evaluated the effect of out-of-pocket fee removal ($45) on DBT versus digital mammography (DM) use across patient groups. The analysis included 13,284 women before and after fee removal (March 2018 to August 2022).

The researchers found that DBT utilization increased from 83.7 percent preintervention to 91.5 percent postintervention. Compared with White patients, the rise in DBT utilization was greater for Asian (5.0 percentage points [pp]), Black (6.2 pp), and Hispanic patients (6.2 pp). A larger increase was seen for non-English-speaking patients compared with English-speaking patients (7.1 pp). Compared with Medicare-covered patients, Medicaid (6.7 pp) and commercially insured (5.1 pp) patients showed a greater rise in DBT usage. Lastly, patients from more socioeconomically disadvantaged areas had a greater increase in DBT utilization versus those from less disadvantaged areas (5.2 pp).

"These findings demonstrate that even modest out-of-pocket costs can create meaningful barriers to accessing advanced screening technology," Capiro said in a statement. "While we saw encouraging improvements across all groups after removing the fee, persistent disparities indicate that additional approaches are needed to ensure truly equitable access."

Abstract/Full Text

Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

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