We quantified weekly medical claims from commercially insured US adults between January 15, 2020, and July 31, 2020. Medical claims data were provided by Castlight Health, a health benefits manager for employer-sponsored health insurance plans across all 50 states, which included 6.8 million individuals.3 We limited the study sample to those ages 46 to 64, target populations for cancer screening procedures prior to Medicare eligibility. For screening mammography, we limited our sample to women. Procedures were identified using IBM Watson Health procedure categories.4 We calculated weekly number of individuals, per 10,000 eligible beneficiaries, who received cancer screenings. We also included patient age category (ages 46–59, 60–64) and sex, and linked claims to county-level demographic characteristics: percent non-Hispanic black and percent Hispanic, and median household income, according to the U.S. Census Bureau; and weekly prevalence of SARS-CoV-2 cases per 10,000 population, according to USAFacts.
Longitudinal multivariable fixed-effects regression analyses estimated change in screening rates following March 13, 2020, relative to prior weeks. Fixed effects were included for calendar year, calendar week, and US state. Standard errors were clustered at the state level. Additional models interacted the dichotomous time variable with demographic characteristics. For each model, marginal means were generated to estimate adjusted, weekly screening rates through July 2020. This study was approved by the RAND IRB.