Studies from Maine Medical Center Research Institute Reveal New Findings on Managed Care (National Recommendations Against Prostate Specific Antigen Screening Versus Statewide Medicaid Expansion Initiatives: a Battle of the Titans): Managed Care

NewsRx Policy and Law Daily

2022 APR 21 (NewsRx) -- By a News Reporter-Staff News Editor at NewsRx Policy and Law Daily -- Investigators discuss new findings in Managed Care. According to news originating from Portland, Maine, by NewsRx correspondents, research stated, “Medicaid expansion under the Patient Protection and Affordable Care Act occurred almost concurrently with 2012 U.S. Preventive Services Task Force recommendations against prostate specific antigen screening.”

Our news journalists obtained a quote from the research from Maine Medical Center Research Institute, “Here the relative influence on prostate specific antigen screening rates by 2 concurrent and opposing system-level policy initiatives is investigated: improved access to care and change in clinical practice guidelines. Behavioral Risk Factor Surveillance System data from years 2012 to 2018 were analyzed for trends in self-reported prostate specific antigen screening and insurance coverage. Subanalyses included state Medicaid expansion status and respondent federal poverty level. Multivariable logistic regression was performed to evaluate factors associated with prostate specific antigen screening. From 2012 to 2018 prostate specific antigen screening predominantly declined with a notable exception of an increase of 7.3% for men at <138% federal poverty level between 2011 and 2013 in early expansion states. Initial increases did not continue, and screening trends mirrored those of nonexpansion states by 2018. Notably, 2014 planned expansions states did not follow this trend with minimal change between 2015 and 2017 compared to declines in early expansion states and nonexpansion states (-0.4% vs -6.7% and -8.6%, respectively). Medicaid expansion was associated with increased rates of insured men at <138% federal poverty level from 2012 to 2018 in early expansion states. In this group, initial increases in prostate specific antigen screening were not durable and followed the trend of reduced screening seen across the United States. In planned expansions states the global drop in prostate specific antigen screening from 2016 to 2018 was offset in men at <138% federal poverty level by expanding access to care. Nonexpansion states showed a steady decline in prostate specific antigen screening rates. This suggests that policy such as U.S.”

According to the news editors, the research concluded: “Preventive Services Task Force recommendations against screening competes with and often outmatches access to care.”

This research has been peer-reviewed.

For more information on this research see: National Recommendations Against Prostate Specific Antigen Screening Versus Statewide Medicaid Expansion Initiatives: a Battle of the Titans. Journal of Urology, 2021;205(6):1641-1647. Journal of Urology can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Elsevier - www.elsevier.com; Journal of Urology - http://www.journals.elsevier.com/journal-of-urology/)

The news correspondents report that additional information may be obtained from Jesse D. Sammon, Maine Medical Center Research Institute, Portland, ME, United States. Additional authors for this research include William C. Daly, Joshua A. Linscott, Matthew H. Hayn, Moritz H. Hansen, Stephen T. Ryan, Scot C. Remick and Paul K. J. Han.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1097/ju.0000000000001594. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.