Michigan Improves Quality of Mammography, Access Still an Issue, Detroit Free Press Reports

Because of a 10-year-old "tough state inspection law," the quality of mammograms for Michigan women has "soared," the Detroit Free Press reports. While 10 years ago, one in three mammography machines failed to pass image-quality tests, now only 1% of the state's machines do not meet the standards. Overall, 7% of the state's mammography machines were listed as noncompliant as of March 15, but 6% of those violations "tend[ed] to be minor," and were related to issues other than the machines themselves, such as paperwork. The Free Press reports this finding as part of its "detailed analysis" of the state's 329 mammography facilities, in which the paper compares the costs of mammograms, appointment waiting times and other factors. The guide, published in the April 17 Body & Mind section, identifies four ongoing "problems" with mammography services:

• Cost and insurance reimbursement: The Free Press reports that while the average cost of a mammogram is $128, insurance payment rates "lag behind." For example, Medicaid pays $35.76, Medicare pays $69.23 and Blue Cross and Blue Shield of Michigan pays $103. To offset lower reimbursement rates for mammograms, many centers charge more for other services.
• Underuse of a "federal program that pays for mammograms": Of the estimated 341,000 eligible Michigan women, only 5% got a free mammogram last year.
• Wide ranges in waiting times: Most women are able to get appointments for mammograms within 12 days, but others wait one month or longer.
• Quality violations at some metro Detroit facilities: Oakland County facilities have three times more citations than any other county in the state(Anstett, Detroit Free Press, 4/17).

Improve Reimbursements, Editorial Says
While the quality of mammography in Michigan has improved, that good news "is tempered with bad news for the health centers" that offer mammograms and "do not get reimbursed adequately," a Free Press editorial states. Because some facilities are "generally reimbursed only a fraction of their costs," women who receive mammograms either pay "too much out of pocket" or centers providing the tests "must pass along expenses in other bills or eat their losses," the editorial says. Noting that mammograms have "proved effective in cutting cancer deaths," the Free Press says that any "obstacle, including price, that gets in the way of screening should be lowered, or better, eliminated." But those obstacles should not be removed "at the expense of good monitoring," the editorial cautions. Federal officials are considering cutting back inspections of mammography facilities to every other year rather than once per year, and other officials have proposed eliminating a dual state-federal inspection. But the editorial notes that the "results of double inspection -- as Michigan has shown -- are improved quality and accuracy" (Detroit Free Press, 4/17).