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Medicaid Patients Get Worse Cancer Care: Studies

Researchers found screening, treatments weren't as good as patients with private insurance

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

WEDNESDAY, June 4, 2014 (HealthDay News) -- Medicaid patients appear to receive worse cancer care than people who can afford private insurance, a trio of new studies says.

Those covered by Medicaid, the federal health plan for low-income people, are less likely to have their cancer caught at an earlier, more treatable phase. Medicaid patients also are more likely to die from cancer than people with private insurance, researchers found.

Many factors likely contribute to this, including the fact that Medicaid patients often aren't experienced in navigating the health care system, said Dr. Jyoti Patel, an oncologist at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University in Chicago.

"Research has shown that we can screen more patients, but that they get dropped along the way to treatment. We don't give them full access into curative therapy," said Patel, who's also a spokeswoman for the American Society of Clinical Oncology. "We need to do a better job to make sure that people who aren't savvy or can't advocate for themselves have that helping hand."

The three studies each focused on a different type of cancer and how insurance affects screening or care for patients. They all were presented this week at the American Society of Clinical Oncology annual meeting in Chicago.

The first involved Hodgkin lymphoma, with researchers from the University of Tennessee, Memphis, reviewing data for 6,395 patients treated for the cancer between 2007 and 2010.

Doctors were more likely to catch the person's lymphoma at an earlier stage if they had private insurance. About 59 percent of people with private insurance received a diagnosis before cancer had a chance to spread throughout their body, compared with 50 percent of Medicaid patients.

Medicaid patients were less likely to receive radiation treatment with just 35 percent undergoing the therapy, compared with 43 percent of privately insured patients.

And finally, privately insured patients were more likely to survive, with 84 percent surviving their lymphoma compared with 71 percent of Medicaid patients.

Results from the second study, which involved cases of melanoma, were similar.

Researchers at Case Western Reserve School of Medicine in Cleveland reviewed data for 31,957 patients treated for melanoma between 1996 and 2009 in Ohio.

They found that patients were two and a half times likelier to be diagnosed with late-stage melanoma if they were covered by Medicaid, said lead author Katherine Chiang, a fourth-year medical student at Case Western.

In the final study, researchers found that Chicago women were less likely to receive medically advanced techniques for diagnosing breast cancer if they had Medicaid or Medicare, the government insurance program for older Americans.

Only 47 percent of Medicaid or Medicare patients received a breast MRI, compared with 81 percent of those with private insurance, researchers found.

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