title: Does health insurance coverage of office visits influence colorectal cancer testing?
abstract: OBJECTIVE
  To assess the effect of differing health insurance coverage of physician office visits on the use of colorectal cancer (CRC) tests among an employed and insured population.
  
  
  METHODS
  Cohort study of persons ages 50 to 64 years enrolled in fee-for-service (FFS) or preferred provider organization (PPO) health plans, where FFS plan enrollees bear disproportionate share of office visit coverage, for the period 1995 through 1999.
  
  
  RESULTS
  Compared with FFS plans, enrollees in PPO plans were significantly more likely to obtain CRC tests [adjusted relative risk (RR(a)), 1.27; 95% confidence intervals (CI), 1.21-1.24]. The association was more pronounced among hourly individuals (RR(a), 1.43; 95% CI, 1.41-1.45) than among salaried individuals (RR(a), 1.09; 95% CI, 1.05-1.10), consistent with a greater differential in office visit coverage among the hourly group.
  
  
  CONCLUSIONS
  Disproportionate cost-sharing seems to have a negative effect on the use of CRC tests most likely by discouraging nonacute care physician office visits.
authors.affiliation: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
authors.forename: Reuben K
authors.initials: RK
authors.lastname: Varghese
authors.forename: Carol
authors.initials: C
authors.lastname: Friedman
authors.forename: Faruque
authors.initials: F
authors.lastname: Ahmed
authors.forename: Adele L
authors.initials: AL
authors.lastname: Franks
authors.forename: Marsha
authors.initials: M
authors.lastname: Manning
authors.forename: Laura C
authors.initials: LC
authors.lastname: Seeff
mesh_terms: D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D017047:Cost Sharing; D005260:Female; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000706:statistics & numerical data*; D008875:Middle Aged; D009819:Office Visits; D011243:Preferred Provider Organizations; D012307:Risk Factors