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We used a natural experimental design and employed a difference-in-differences (DID) analysis to identify the net effect of the BCCPTA on breast cancer patients.
The Georgia BCCPTA, the intervention, targets breast cancer patients and they are the treatment cases we study.
We excluded those who were age 65 and over since they are not eligible for the BCCPTA and we would not observe their medical claims once they were in Medicare.
The major independent variables are the BCCPTA pre/post dummy, the breast cancer dummy, and the BCCPTA interacted with the breast cancer dummy; the latter provides a measure of the DID estimate of the net effect of the BCCPTA.
As noted, we tested alternative post-periods at three months, six months, and one year after initial implementation to see whether the effect of the BCCPTA averaged over the full postperiod was affected by the initial "takeup" of the policy by uninsured women who had gone without care in the pre-BCCPTA period.
Finally, [[beta].sub.3] is the estimate of the DID, which is the net effect of the BCCPTA on the probability of early stage disease for breast cancer patients enrolling in Medicaid.
In turn, after the BCCPTA there were 7.5 more breast cases and .5 fewer control cases each month enrolled in Medicaid at an early stage.
Before the BCCPTA, 1.4 women with breast cancer and .2 women with control cancers experienced a progression by the time they enrolled.
The interaction term in the linear probability models (shown in Table 3) represents the net effect of the BCCPTA on early disease stage at Medicaid enrollment after controlling for other factors.
While shedding new information on the effects of the BCCPTA, our study has several limitations.
The effects of the BCCPTA only changed slightly when excluding those covariates in the regression models.
In addition to providing better access to cancer treatment by offering a new source of coverage, the BCCPTA also may result in cancer patients enrolling in Medicaid at an earlier stage of their disease.
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