Abstract IA45: Coverage ≠ access: State Medicaid policies and disparities in receiving high-quality cancer care

Abstract

Abstract Medicaid is a joint state-federal program that provides health insurance coverage to certain low-income populations. While the federal government provides funding for at least half of each state's Medicaid costs and requires coverage for certain health care services, each state has broad flexibility to design its own Medicaid policies. These policies include reimbursement rates for medical care services, requirements for patient copayments, and duration of Medicaid enrollment before required eligibility recertification. Furthermore, following the 2012 Supreme Court decision, states can choose whether to participate in expansion of Medicaid to enroll individuals with incomes up to 138% of the Federal Poverty Level. As these policies differ substantially among states, Medicaid is not a single health insurance plan but a set of different plans for each state. Medicaid provides coverage for cancer screening and treatment for many low-income individuals. However, differences in state Medicaid policies may affect receipt of timely and high-quality cancer care for this underserved population. In addition, social determinants of health such as race/ethnicity, sex, and age may also affect receipt of cancer care among Medicaid beneficiaries. This presentation will review findings examining the effects of state Medicaid policies and individual characteristics on receiving cancer screening, treatment, supportive care, and survivorship care services among Medicaid beneficiaries. Using Medicaid claims and enrollment data, research has found that both state policies and social determinants of health can impact receipt of recommended cancer screenings and treatment for individuals with Medicaid coverage. The impacts of Medicaid policies vary for different types of cancer care services and among individuals with different types of cancer. State decisions to participate in Medicaid expansion also affect receipt of cancer care. These findings highlight the need for state Medicaid policies designed to improve access to cancer care and enhance outcomes among Medicaid beneficiaries. Given the large—and growing—Medicaid population, even small improvements in access to high-quality cancer care can translate into substantial changes in health outcomes. Citation Format: Michael T. Halpern. Coverage ≠ access: State Medicaid policies and disparities in receiving high-quality cancer care [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr IA45.