title: Declining mammography screening in a state Medicaid Fee-for-Service program: 1999-2008.
abstract: OBJECTIVE
  To evaluate and compare annual and biennial mammography screening rates across age, race, and geographic location (rural-urban) and to determine mammography screening persistence over 10 years among women enrolled in the West Virginia (WV) Medicaid Fee-for-Service (FFS) program.
  
  
  METHODS
  The WV Medicaid FFS administrative claims data for women recipients aged 40-64 from 1999 to 2008 were used for study purposes. Annual and biennial screening rates and persistence with screening were determined for women who were continuously enrolled in the WV Medicaid FFS program for respective calendar years.
  
  
  RESULTS
  A steady decline in the annual and biennial screening rates over a 10-year period (1999-2008) was observed among women recipients aged 40-64 years in the WV Medicaid FFS program, and screening persistence was also lower. Both annual and biennial screening rates and persistence varied by different demographic characteristics.
  
  
  CONCLUSIONS
  Although mammography screening services are covered under Medicaid programs, underuse persists as a major concern. The results of this study emphasize the need to identify and address barriers to mammography screening in low-income rural populations.
authors.affiliation: Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia 26506, USA. contact.abhijeet@gmail.com
authors.forename: Abhijeet
authors.initials: A
authors.lastname: Bhanegaonkar
authors.forename: S Suresh
authors.initials: SS
authors.lastname: Madhavan
authors.forename: Rahul
authors.initials: R
authors.lastname: Khanna
authors.forename: Scot C
authors.initials: SC
authors.lastname: Remick
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D018588:Fee-for-Service Plans / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D017048:Health Care Costs; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D008403:Mass Screening / Q000706:statistics & numerical data* / Q000639:trends; D008484:Medicaid / Q000191:economics* / Q000592:standards; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D015397:Program Evaluation; D011632:Public Assistance; D012189:Retrospective Studies; D012424:Rural Population / Q000706:statistics & numerical data / Q000639:trends; D013997:Time Factors; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data / Q000639:trends; D014903:West Virginia