Reimbursement for Screening Mammography—The Medicare Disparity: A Policy Perspective

Abstract

olicy analysis and development models provide nurses the framework needed to identify and assimilate pertinent information related to specific professional concerns. Policy analysis models identify attributes and deficits relating to specific policy issues and provide the groundwork for problem identification and policy development. The stage sequential model (Ripley, 1996) is a systems-based model that views the policy process sequentially or in a series of steps (see Figure 1). This model identifies specific policy problems and places them on the policy agenda for further development, implementation, and evaluation. The stage sequential model will be used to analyze the current Medicare reimbursement system for screening mammography for elderly women in the United States. Within this model, problems are identified related to the current reimbursement structure. In accordance with the model's sequential steps, the process is developed, adopted, implemented, and evaluated. 240 Ripley's stage sequential model is used to analyze the disparity in the Medicare reimbursement for screening mammography for older women in the United States. The article presents a historical review of the policy issue and suggests solutions to set the agenda for policy change. Problem identification, costs, and ethical and social issues are evaluated, and policy change is recommended.

Multiple Imputation for Missingness Due to Nonlinkage and Program Characteristics

“…For this paper, we used 2004–2005 NHIS data linked to 1999–2004 Medicare data to estimate annual percentages of women aged 65 years and older in the FFS program who have mammography screening. Medicare data contain mammography claims information that have been used to study mammography screening among women, particularly those aged 65 years and older (e.g., Townsend-Rocchiccioli and Steele 2002; Braithwaite, Zhu, Hubbard, O’Meara, Miglioretti et al 2013). All women aged 40 years and older with Medicare coverage can be reimbursed for a screening mammogram every 12 months.…”