The Early Impact of the Affordable Care Act upon Colorectal Cancer Screening Utilization in Florida

Authors

Aldenise P. Ewing, Moffitt Cancer CenterFollow
Laura Baum, RTI InternationalFollow
Rosalyn Roker, University of South Florida, College of Aging StudiesFollow
Marlene Joannie Bewa, University of South Florida, College of Public HealthFollow
Tali Schneider, James A. Haley Veterans Research & Development ServiceFollow
Claudia F. Parvanta, University of South Florida, College of Public HealthFollow
Clement K. Gwede, Moffitt Cancer CenterFollow
Cathy D. Meade, Moffitt Cancer CenterFollow
Dinorah Martinez Tyson, University of South Florida, College of Public HealthFollow

Keywords

Insurance; Barriers; Healthcare; Patient; Medical; Facilitators; Providers; Policy

Disciplines

Community Health and Preventive Medicine | Health Law and Policy | Health Services Research | Public Health Education and Promotion | Social and Behavioral Sciences

Abstract

Background: Colorectal cancer is the second leading cause of cancer-related deaths in the United States. Although preventable and curable through screening, early detection and treatment, a lack of health insurance is a major obstacle to receiving colorectal cancer screening (CRCS). Despite the Affordable Care Act (ACA) increasing access to health insurance by mandating coverage of CRCS, disparities in utilization rates continue. Therefore, researchers sought to better understand ACA related facilitators and impediments that affect the utilization of CRCS and collect specific recommendations from healthcare professionals to increase screening utilization rates in Florida.

Methods: Researchers conducted in-depth interviews with 22 healthcare professionals. Data were coded and analyzed using an applied thematic analysis approach and interpreted according to levels of the Social Ecological Model.

Results: Eight physicians and nurses, 7 healthcare workers/care coordinators, 5 administrators and insurers, and 2 health advocates completed interviews. In their view, the early days of the ACA facilitated CRCS uptake through use of frontline staff, patient provider communication, and increased access to healthcare. Barriers that remained, included out of pocket patient costs, limited Medicaid expansion, acceptance of ACA plans by only certain providers and removal of patient incentives. Recommendations for increasing CRCS included more promotion and awareness, removing costs and ensuring patient navigation.

Conclusions: The ACA offered increased access to healthcare coverage, utilization of CRCS and encouraged better communication between healthcare providers and patients. However, persistent barriers remain and include varied CRCS-related patient costs and restricted provider networks included in ACA sponsored plans. Continued healthcare policy reform is needed to make CRCS affordable for all Americans.

Recommended Citation

Ewing, Aldenise P.; Baum, Laura; Roker, Rosalyn; Bewa, Marlene Joannie; Schneider, Tali; Parvanta, Claudia F.; Gwede, Clement K.; Meade, Cathy D.; and Martinez Tyson, Dinorah (2020) "The Early Impact of the Affordable Care Act upon Colorectal Cancer Screening Utilization in Florida," Journal of Health Disparities Research and Practice: Vol. 13: Iss. 3, Article 3.
Available at: https://digitalscholarship.unlv.edu/jhdrp/vol13/iss3/3