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Colorectal Cancer Screening and State Health Insurance Mandates
Author(s) -
Hamman Mary K.,
Kapinos Kandice A.
Publication year - 2016
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/hec.3132
Subject(s) - behavioral risk factor surveillance system , medicine , mandate , colorectal cancer , health insurance , colorectal cancer screening , demography , gerontology , cancer , environmental health , family medicine , health care , colonoscopy , population , sociology , political science , law , economics , economic growth
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. Copyright © 2014 John Wiley & Sons, Ltd.