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Grant Details

Grant Number: 5R21CA219229-02 Interpret this number
Primary Investigator: Whaley, Christopher
Organization: Rand Corporation
Project Title: Using Big Data to Estimate the Effects of Complex Cost-Sharing Rules on Colorectal Cancer Screening and Patient Health
Fiscal Year: 2018


Colorectal cancer is the third-leading cause of cancer-related mortality and approximately 5% of individuals will develop colorectal cancer during their lifetimes. However, colorectal cancer is highly preventable if detected early. Colonoscopies are the most common form of colorectal cancer screenings and all adults between the ages of 50 and 74 are recommended to receive a colonoscopy at least once every 10 years. This study will examine how two recent policies, coverage mandates and high-deductible health plans, that change consumer cost-sharing for colonoscopies have changed patient adherence to these guidelines among the commercially insured population. This study will also examine how changes in patient utilization of colonoscopies have led to changes in colorectal cancer detection and mortality. These policies have created a rapidly changing cost- sharing environment for patients and so fully understanding the patient health effects of these policies is will help inform policy makers on the patient health effects of these changes. Recent years have also seen a rapid increase in data, computing power, and analytical methodologies. This study will apply recent advances in data mining techniques to one of the largest sources of data available to researchers. The machine learning approaches used in this study will two sources of bias that are potentially present in traditional approaches—multiple hypothesis testing and selective reporting of results. The machine learning model approaches will also be used to estimate heterogeneity in treatment effects, which will help inform policy makers of how to tailor cost-sharing policies for colonoscopy services.


Understanding the distributional impacts of health insurance reform: Evidence from a consumer cost-sharing program.
Authors: Aouad M. , Brown T.T. , Whaley C.M. .
Source: Health economics, 2021 Nov; 30(11), p. 2780-2793.
EPub date: 2021-08-21.
PMID: 34418216
Related Citations

Reference-Based Benefits for Colonoscopy and Arthroscopy: Large Differences in Patient Payments Across Procedures but Similar Behavioral Responses.
Authors: Brown T.T. , Guo C. , Whaley C. .
Source: Medical care research and review : MCRR, 2020 Jun; 77(3), p. 261-273.
EPub date: 2018-08-13.
PMID: 30103654
Related Citations

Reference pricing: The case of screening colonoscopies.
Authors: Aouad M. , Brown T.T. , Whaley C.M. .
Source: Journal of health economics, 2019 May; 65, p. 246-259.
EPub date: 2019-03-29.
PMID: 31082768
Related Citations

Paying Patients To Switch: Impact Of A Rewards Program On Choice Of Providers, Prices, And Utilization.
Authors: Whaley C.M. , Vu L. , Sood N. , Chernew M.E. , Metcalfe L. , Mehrotra A. .
Source: Health affairs (Project Hope), 2019 Mar; 38(3), p. 440-447.
PMID: 30830823
Related Citations

The moral hazard effects of consumer responses to targeted cost-sharing.
Authors: Whaley C.M. , Guo C. , Brown T.T. .
Source: Journal of health economics, 2017 Dec; 56, p. 201-221.
EPub date: 2017-10-12.
PMID: 29111500
Related Citations

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