Abstract 45: Trends in Cardiovascular Disease (CVD) Risk Factor Screening and Counseling: Impact of the Affordable Care Act (ACA)
Introduction: The Affordable Care Act (ACA), signed into law in 2010, was incrementally implemented by a series of reforms including an expansion of health insurance coverage and preventive services coverage without co-pay. It is not known whether CVD preventive services have increased as a result of enhanced healthcare access.
Hypothesis: We hypothesized that CVD risk factor screening and counseling would increase among US adults over the period of ACA implementation, 2011-2015.
Methods: The National Health Interview Survey is a telephone survey of a random sample of the US civilian noninstitutionalized population. Respondents (n=101,243) from survey years 2011, 2013, and 2015 were asked whether, in the past year, they had a screening test for blood pressure, cholesterol, and diabetes, and counseling about diet and smoking cessation from a health professional. We calculated annual percent change (APC) for each preventive service, using weighted constant-time Cox regression models, and examined whether findings were similar across demographic groups.
Results: Health insurance coverage increased from 2011-2015, primarily among lower socioeconomic status (SES) individuals and younger adults. There were significant annual increases in the prevalence of screening and counseling for each CVD risk factor (Table). Increases were larger among lower SES groups for blood pressure and cholesterol screenings. Increases were larger among younger age groups for blood pressure, cholesterol, and diabetes screenings, but were larger among older, Medicare-eligible adults for diet counseling. There were no significant differences in APC increases by gender or race.
Conclusions: CVD risk factor screening and counseling increased during ACA implementation. Differential increases across SES and age groups indicate improved access to care in populations that have been previously underserved. Outreach is needed to ensure newly insured persons are aware of covered CVD preventive services.
Author Disclosures: L. Pool: None. E. Akhabue: None. M.R. Carnethon: None.
This research has received full or partial funding support from the American Heart Association, National Center.
- © 2017 by American Heart Association, Inc.