The overall objective of this study is to examine the influence of enrollment into high deductible health plans on likelihood of being up-to-date on cancer screening and prevention services (screening mammograms, Pap tests, and HPV vaccinations) compared to enrollment in traditional HMO plans among age-eligible women. Analysis uses a quasi-experimental design in which age-eligible women enrolled in a high deductible plan are propensity score matched with age-eligible women enrolled in a traditional HMO plan. The overall working hypothesis is that enrollment in a high deductible plan will decrease the likelihood of being up-to-date on one or more of these services either directly or indirectly as a consequence of the higher levels of patient cost-sharing compared to traditional HMO plans. Two Kaiser Permanente (KP) regions -- KP Colorado and KP Georgia -- are participating in the study. The study covers the period 2000-2007 for screening mammogram and Pap tests and 2006-2009 for HPV vaccinations.
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