Avalere Data on Breast Cancer Screening Disparities Published in AJMC
Summary
Avalere analysis conducted in collaboration with the Community Oncology Alliance (COA) was published in the American Journal of Managed Care, showing disparities in breast cancer screening rates during the COVID-19 pandemic among racial and ethnic minority groups and based on insurance type.The COVID-19 pandemic continues to impact patients’ ability to access care, but it has also heightened attention on health disparities and social determinants of health. Avalere Health has partnered with COA since 2020 conducting analyses on how the pandemic has disrupted the spectrum of cancer care, including delaying diagnoses and treatment. The latest study “Considerations to Increase Rates of Breast Cancer Screening Across High-Risk Populations” found a large disruption in monthly mammogram utilization between March 2020 and May 2020, inclusive, when compared to the same period during 2019. Moreover, the “return to normal” for breast cancer screening adherence was faster among White Medicare Fee-For-Service (FFS) beneficiaries compared to non-White Medicare FFS beneficiaries during the summer of 2021. Screening rate disparities were also observed across payers, with Managed Medicaid beneficiaries having the lowest screening rates, compared with those covered by commercial and Medicare FFS insurance. The analysis also highlighted the relationship between screening adherence and median household income.
The study utilized Inovalon’s MORE2 Registry®, a multi-payer database that captures the enrollment and claims data of more than 338 million commercial, Medicare FFS, Medicare Advantage, and Managed Medicaid beneficiaries, as well as Acxiom’s InfoBase® Geo database, to integrate patient-specific social determinants of health information at the 5-digit ZIP code level. The goals of the analysis were to measure adherence to United State Preventive Services Task Force (USPSTF) breast cancer screening guidelines before and during the emergence of COVID-19 and to evaluate whether the PHE differentially impacted screening utilization among certain high-risk sub-populations.
The results can be used to inform revisions to the USPSTF breast cancer recommendation and will support better understanding of how and to what extent the pandemic has the exacerbated health disparities in patient care, as outlined in President Biden’s revitalized Cancer Moonshot Initiative.
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