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The Effect of Informative Letters on the Prescription and Receipt of Schedule II Controlled Substances

Last registered on October 06, 2014

Pre-Trial

Trial Information

General Information

Title
The Effect of Informative Letters on Fraud and Abuse in Medicare
RCT ID
AEARCTR-0000525
Initial registration date
October 06, 2014

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
October 06, 2014, 4:37 PM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

Region

Primary Investigator

Affiliation
Columbia University

Other Primary Investigator(s)

PI Affiliation
Massachusetts Institute of Technology

Additional Trial Information

Status
In development
Start date
2014-08-01
End date
2016-10-01
Secondary IDs
Abstract
Fraud and waste is estimated to cost the American health care system nearly $200 billion each year, and the public Medicare and Medicaid programs about $60 billion each year. This study will evaluate a new method for fighting fraud: mailing informative letters to outlier providers to notify them of their aberrant behavior. We will look at the effects of these letters on the behavior of providers and their patients. These effects are of substantial policy interest as they suggest how to best design anti-fraud policies. They are also of academic interest, shedding light on the behavior of physicians and their patients.
External Link(s)

Registration Citation

Citation
Finkelstein, Amy and Adam Sacarny. 2014. "The Effect of Informative Letters on Fraud and Abuse in Medicare." AEA RCT Registry. October 06. https://doi.org/10.1257/rct.525-1.0
Former Citation
Finkelstein, Amy and Adam Sacarny. 2014. "The Effect of Informative Letters on Fraud and Abuse in Medicare." AEA RCT Registry. October 06. https://www.socialscienceregistry.org/trials/525/history/2831
Sponsors & Partners

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Experimental Details

Interventions

Intervention(s)
A letter or series of letters to providers explaining that their behavior is highly unlike their peers.
Intervention (Hidden)
Intervention Start Date
2014-09-11
Intervention End Date
2015-10-01

Primary Outcomes

Primary Outcomes (end points)
The primary endpoint of this trial will be the outcome targeted by the letter campaign. For example, in a letter targeting outlier prescribers of a controlled substance, the target will be the count of prescriptions of this controlled substance by the prescriber.
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
Working with CMS, we will identify potentially fraudulent providers on a set of dimensions using administrative billing claims data. Once the providers have been identified, we will randomly select half of the providers (the treatment group) to receive the intervention: an informative letter.
Experimental Design Details
Randomization Method
Randomization done by computer
Randomization Unit
The provider (e.g. physician, nurse, physician assistant, etc.)
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
Approximately 1500 providers per letter campaign
Sample size: planned number of observations
Approximately 1500 providers per letter campaign
Sample size (or number of clusters) by treatment arms
Approximately 750 providers in the control arm and 750 providers in the treatment arm, per campaign
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB

Institutional Review Boards (IRBs)

IRB Name
Harvard Committee on the Use of Human Subjects in Research
IRB Approval Date
2014-09-19
IRB Approval Number
IRB14-3112
Analysis Plan

Analysis Plan Documents

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
No
Data Collection Complete
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials