Colorectal Cancer Screening and State Health Insurance Mandates

Mary K. Hamman; Kandice A. Kapinos

doi:10.1002/hec.3132

Colorectal Cancer Screening and State Health Insurance Mandates

Mary K. Hamman, Kandice A. Kapinos

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Colorectal cancer (CRC) is the third most deadly cancer in the USA. CRC screening is the most effective way to prevent CRC death, but compliance with recommended screenings is very low. In this study, we investigate whether CRC screening behavior changed under state mandated private insurance coverage of CRC screening in a sample of insured adults from the 1997 to 2008 Behavioral Risk Factor Surveillance Survey (BRFSS). We present difference-in-difference-in-differences (DDD) estimates that compare insured individuals age 51 to 64 to Medicare age-eligible individuals (ages 66 to 75) in mandate and non-mandate states over time. Our DDD estimates suggest endoscopic screening among men increased by 2 to 3 percentage points under mandated coverage among 51 to 64 year olds relative to their Medicare age-eligible counterparts. We find no clear evidence of changes in screening behavior among women. DD estimates suggest no evidence of a mandate effect on either type of CRC screening for men or women.

Original language	English (US)
Pages (from-to)	178-191
Number of pages	14
Journal	Health Economics (United Kingdom)
Volume	25
Issue number	2
DOIs	https://doi.org/10.1002/hec.3132
State	Published - Feb 1 2016
Externally published	Yes

Keywords

cancer screening
health insurance mandates

ASJC Scopus subject areas

Health Policy

Access to Document

10.1002/hec.3132

Cite this

@article{3b4306ab9f6b4455834f1c6c262f4de7,

title = "Colorectal Cancer Screening and State Health Insurance Mandates",

abstract = "Colorectal cancer (CRC) is the third most deadly cancer in the USA. CRC screening is the most effective way to prevent CRC death, but compliance with recommended screenings is very low. In this study, we investigate whether CRC screening behavior changed under state mandated private insurance coverage of CRC screening in a sample of insured adults from the 1997 to 2008 Behavioral Risk Factor Surveillance Survey (BRFSS). We present difference-in-difference-in-differences (DDD) estimates that compare insured individuals age 51 to 64 to Medicare age-eligible individuals (ages 66 to 75) in mandate and non-mandate states over time. Our DDD estimates suggest endoscopic screening among men increased by 2 to 3 percentage points under mandated coverage among 51 to 64 year olds relative to their Medicare age-eligible counterparts. We find no clear evidence of changes in screening behavior among women. DD estimates suggest no evidence of a mandate effect on either type of CRC screening for men or women.",

keywords = "cancer screening, health insurance mandates",

author = "Hamman, {Mary K.} and Kapinos, {Kandice A.}",

note = "Funding Information: The authors are grateful to Katie Carman, Ezra Golberstein, Helen Levy, Kosali Simon, and anonymous referees for their feedback on earlier drafts. The authors also wish to thank participants at AcademyHealth, the American Society of Health Economists, the Census Bureau, the Minneapolis Veterans Affairs Medical Center, the Minnesota Population Center at the University of Minnesota, the RAND Corporation, and the University of Wisconsin La Crosse for their comments. This work was supported in part by the United States Department of Veterans Affairs, Office of Research and Development, Health Services Research and Development Service (grant # LIP-42-126 to HSG). Disclaimers: The views expressed in this article are those of the authors and do not necessarily represent the position or policy of the Department of Veterans Affairs. Publisher Copyright: Copyright {\textcopyright} 2014 John Wiley & Sons, Ltd.",

year = "2016",

month = feb,

day = "1",

doi = "10.1002/hec.3132",

language = "English (US)",

volume = "25",

pages = "178--191",

journal = "Health Economics (United Kingdom)",

issn = "1057-9230",

publisher = "John Wiley and Sons Ltd",

number = "2",

}

TY - JOUR

T1 - Colorectal Cancer Screening and State Health Insurance Mandates

AU - Hamman, Mary K.

AU - Kapinos, Kandice A.

N1 - Funding Information: The authors are grateful to Katie Carman, Ezra Golberstein, Helen Levy, Kosali Simon, and anonymous referees for their feedback on earlier drafts. The authors also wish to thank participants at AcademyHealth, the American Society of Health Economists, the Census Bureau, the Minneapolis Veterans Affairs Medical Center, the Minnesota Population Center at the University of Minnesota, the RAND Corporation, and the University of Wisconsin La Crosse for their comments. This work was supported in part by the United States Department of Veterans Affairs, Office of Research and Development, Health Services Research and Development Service (grant # LIP-42-126 to HSG). Disclaimers: The views expressed in this article are those of the authors and do not necessarily represent the position or policy of the Department of Veterans Affairs. Publisher Copyright: Copyright © 2014 John Wiley & Sons, Ltd.

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Colorectal cancer (CRC) is the third most deadly cancer in the USA. CRC screening is the most effective way to prevent CRC death, but compliance with recommended screenings is very low. In this study, we investigate whether CRC screening behavior changed under state mandated private insurance coverage of CRC screening in a sample of insured adults from the 1997 to 2008 Behavioral Risk Factor Surveillance Survey (BRFSS). We present difference-in-difference-in-differences (DDD) estimates that compare insured individuals age 51 to 64 to Medicare age-eligible individuals (ages 66 to 75) in mandate and non-mandate states over time. Our DDD estimates suggest endoscopic screening among men increased by 2 to 3 percentage points under mandated coverage among 51 to 64 year olds relative to their Medicare age-eligible counterparts. We find no clear evidence of changes in screening behavior among women. DD estimates suggest no evidence of a mandate effect on either type of CRC screening for men or women.

AB - Colorectal cancer (CRC) is the third most deadly cancer in the USA. CRC screening is the most effective way to prevent CRC death, but compliance with recommended screenings is very low. In this study, we investigate whether CRC screening behavior changed under state mandated private insurance coverage of CRC screening in a sample of insured adults from the 1997 to 2008 Behavioral Risk Factor Surveillance Survey (BRFSS). We present difference-in-difference-in-differences (DDD) estimates that compare insured individuals age 51 to 64 to Medicare age-eligible individuals (ages 66 to 75) in mandate and non-mandate states over time. Our DDD estimates suggest endoscopic screening among men increased by 2 to 3 percentage points under mandated coverage among 51 to 64 year olds relative to their Medicare age-eligible counterparts. We find no clear evidence of changes in screening behavior among women. DD estimates suggest no evidence of a mandate effect on either type of CRC screening for men or women.

KW - cancer screening

KW - health insurance mandates

UR - http://www.scopus.com/inward/record.url?scp=84955184803&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84955184803&partnerID=8YFLogxK

U2 - 10.1002/hec.3132

DO - 10.1002/hec.3132

M3 - Article

C2 - 25521438

AN - SCOPUS:84955184803

SN - 1057-9230

VL - 25

SP - 178

EP - 191

JO - Health Economics (United Kingdom)

JF - Health Economics (United Kingdom)

IS - 2

ER -

Colorectal Cancer Screening and State Health Insurance Mandates

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this