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Atlanta Fed Working Papers


The Influence of Year-End Bonuses on Colorectal Cancer Screening

Brian S. Armour, Carol Friedman, M. Melinda Pitts, Jennifer Wike, Linda Alley, and Jeff Etchason
Working Paper 2003-41
December 2003

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The objective of the paper is to estimate the effect of physician bonus eligibility on CRC screening while controlling for patient and primary care physician characteristics. The study is retrospective, using a managed care plan’s claims data on fifty-year-old commercially insured patients in the years 2000 and 2001. The data also include links to enrollment and provider files. Multivariate logistic regression models are used to assess the association between CRC screening receipt and physician bonus eligibility. The results indicate that the probability that a patient received a CRC screening was approximately 3 percentage points higher in the year physicians were eligible for a bonus. There were also significant differences according to the gender of both the patient and physician, income, and race.

JEL classification: I10

Key words: managed care, primary care physicians, bonuses, colorectal cancer screening


The authors gratefully acknowledge the Centers for Disease Control and Prevention, Atlanta, Georgia; the Alliance of Community Health Plans, Washington, D.C.; and the Georgia Cancer Coalition. The views expressed here are the authors’ and not necessarily those of the Centers for Disease Control and Prevention, the Alliance of Community Health Plans, the Georgia Cancer Coalition, the Federal Reserve Bank of Atlanta, or the Federal Reserve System. Any remaining errors are the authors’ responsibility.

Please address questions regarding content to M. Melinda Pitts, Research Department, Federal Reserve Bank of Atlanta, 1000 Peachtree Street, NE, Atlanta, GA 30309-4470, 404-498-7009, melinda.pitts@atl.frb.org.

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