Women are confused about the importance of the exams because of conflicting guidelines by leading organizations about the benefit of the tests in women ages 40 to 50. There's agreement that women 50 and older should have annual mammograms. Language, cultural and transportation barriers pose other problems. But cost is increasingly a major problem. It may have replaced machine issues as the top hurdle, both in getting more women to have mammograms and in allowing centers to add new technology.
Most centers offset the lower rates of reimbursement by charging more for other services.
Many say they offer low mammogram prices as a public service. The National Academies of Science report on mammography recommended that the federal Health Care Financing Administration analyze Medicaid and Medicare reimbursement rates to determine whether costs were covered adequately. Some relief will come next year when Medicare phases in increased reimbursements, but no one knows yet how much they will be. Medicare recently agreed to reimburse digital mammography at a higher rate to offset the costs of buying the machines. The problem, though, has many experts in the field wondering about how to bring costs down.