Milestones and Honors: CDC Honors Dr. Sandra Decker

Dr. Sandra Decker, Distinguished Consultant,  Office of Analysis and Epidemiology (OAE), was honored by CDC’s Health Economics Research Group with the 2013 Kaafee Billah Memorial Award for outstanding health economics research. The award ceremony took place on January 28, 2014, at the National Center for Health Statistics campus in Hyattsville, MD. Dr. Scott Grosse, CDC’s Associate Director for Health Services Research and Evaluation, presented Dr. Decker with the award.

The Health Economics Research Group recognized Dr. Decker for her paper, “Decker SL, Doshi JA, Knaup AE, Polsky D. Health service use among the previously uninsured: Is subsidized health insurance enough? Health Econ 21(10):1155-68. 2012.” The study looked at the relationship between insurance status before age 65 and the use of Medicare-covered services beginning at age 65. To help establish utilization patterns, Dr. Decker and her co-authors relied on NCHS’s data linkage program. They used Medicare claims data linked to NCHS’s National Health Interview Survey, which included insurance data collected from respondents from 1999 to the present. (The authors also used data from the University of Michigan Health and Retirement Study.)

Dr. Decker’s study found that, “…individuals who were uninsured before age 65 years continue to use the healthcare system differently from those who were privately insured. Specifically, they have 16% fewer visits to office-based physicians [after the age of 65] but make 18% and 43% more visits to hospital emergency and outpatient departments, respectively.”

In her remarks at the awards ceremony, Dr. Decker said that she and her colleagues were interested in seeing what would happen to uninsured people who are in their 50s and 60s after they became eligible for Medicare and a fuller range of medical services, including physician visits. Would they see a big spike? Rather than seeing a jump in health costs among this group, they found that costs stayed relatively level. “Some who didn’t have insurance before [age] 65 [years] continue to avoid the health care system. They don’t change their behavior,” she said. Dr. Decker noted that the survey covered a heterogeneous group, ranging from extremely healthy to extremely sick persons.

This is the second time Dr. Decker has received the Billah Award. She won the award in 2010 for her paper, “Changes in Medicaid physician fees and patterns of ambulatory care,” published in the Fall 2009 issue of the journal Inquiry. The paper found that reducing Medicaid physician fees can affect Medicaid patients’ access to care. The study was also the co-winner of CDC’s 2010 Charles C. Shepard Science Award.

The Kaafee Billah Memorial Award was established in 2008 to recognize outstanding scientific contributions in economic research at CDC. The award is given annually by the Health Economics Research Group to an outstanding published scientific contribution by a CDC scientist that applies economic methods, theories, and knowledge to analyze a public health problem in the previous year.