For Medicaid-Insured Sufferers With Most cancers, Well being Insurance coverage Does Not All the time Imply Well being-Care Entry – The ASCO SubmitAugust 17, 2022
By The ASCO Submit Workers
Posted: 7/19/2022 1:18:00 PM
Final Up to date: 7/19/2022 1:40:52 PM
Though there was a big enhance within the variety of U.S. residents insured by means of Medicaid for the reason that Affected person Safety and Reasonably priced Care Act was signed into legislation in March 2010, the flexibility of Medicaid-insured sufferers to entry most cancers care companies has not been properly understood. In a examine printed by Marks et al in JAMA Community Open, researchers from Yale Most cancers Heart assessed the acceptance of Medicaid insurance coverage amongst sufferers recognized with frequent cancers.
Michael Leapman, MD, MHS
“We discovered that Medicaid acceptance differed extensively throughout most cancers care amenities, with a considerable variety of facilities not providing companies to sufferers with Medicaid insurance coverage,” mentioned Michael Leapman, MD, MHS, Affiliate Professor of Urology, Medical Program Chief for the Prostate & Urologic Cancers Program at Yale Most cancers Heart and Smilow Most cancers Hospital, and senior writer on the examine.
Key Findings and Implications
Within the examine led by first writer Victoria Marks, a second-year medical pupil at Yale, 334 Fee on Most cancers–accredited amenities had been sampled, of which solely 226 (67.7%) accepted new sufferers with Medicaid insurance coverage for the 4 frequent cancers chosen (colorectal, breast, kidney, and pores and skin cancers). Acceptance different among the many amenities, with 296 (88.6%) accepting Medicaid for no less than three varieties, 324 (97.0%) for no less than two, and 331 (99.1%) for no less than one. Collectively, these findings underscore the persistent gaps that exist for sufferers with Medicaid in using companies at hospitals distinguished for high-quality most cancers care.
“This examine underscores that having medical insurance alone doesn’t essentially imply that sufferers can virtually entry well being care. Whereas main current expansions of Medicaid have led to will increase in medical insurance protection for People with most cancers, we have now to remember and do extra to make sure that insurance coverage will really translate to well timed and high-quality care,” mentioned Dr. Leapman.
Facilitates that had been extra possible than others to simply accept sufferers with Medicaid included Nationwide Most cancers Institute–designated most cancers facilities—89.7% of which provided excessive entry to sufferers with Medicaid—and educational facilities (86.4%). Furthermore, amenities positioned in states that expanded Medicaid had been additionally extra prone to provide excessive entry to Medicaid sufferers: 71.3% vs 59.6%.
“The outcomes of this examine don’t essentially imply that sufferers will be unable to entry care anyplace, however might require a circuitous and impractical path, and is probably not seen at facilities designated for most cancers care,” Dr. Leapman defined.
In response to Dr. Leapman, discovering options that enhance entry for People with Medicaid will likely be complicated. “Regardless of a big enhance within the variety of Medicaid-insured sufferers, most components that restrict a hospital or doctor’s participation in Medicaid haven’t modified,” he mentioned. “These embrace low reimbursement, excessive administrative burden, and restricted specialist participation in managed care group networks. Even modest will increase in reimbursement might have a optimistic affect, and progress in cost constructions that prioritize health-care high quality are promising as properly. Nonetheless, figuring out these gaps in entry is a crucial first step that may direct consciousness.”
Disclosure: For full disclosures of the examine authors, go to jamanetwork.com.