Association between Medicaid expansion status and lung cancer screening exam growth: findings from the ACR lung cancer registry

Gupta, Neal; Halpern, Ethan J.; Rao, Vijay M.

doi:10.1016/j.clinimag.2020.11.056

Cited by 3 publications

(4 citation statements)

References 24 publications

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“…In 2011, the newly established National Prevention Council proposed concrete measures and goals to promote tobacco-free environments (eg, reduce cost of cessation programs) . Despite US Preventive Services Task Force recommendations for lung cancer screening, fewer than 5% of eligible individuals are screened, a low rate that has yet to be affected by Medicaid expansion, highlighting the need for more work . The Patient-Centered Outcomes Research Institute funds comparative effectiveness research with a recent focus on care delivery, including strategies to improve uptake of lung and colorectal cancer screening …”

Section: How Expansion Altered Medicaidmentioning

confidence: 99%

“…More recent studies have attributed a survival benefit to Medicaid expansion for cancers with a particularly poor prognosis (eg, esophageal and pancreatic cancer). However, for most aspects of cancer care that have been studied, results have been mixed, with many studies generating differing or even opposing conclusions (Table 2).…”

Section: Opportunities To Study the Association Of Medicaid Expansion...mentioning

confidence: 99%

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Understanding the Implications of Medicaid Expansion for Cancer Care in the US

et al. 2022

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Insurance status has been linked to important differences in cancer treatment and outcomes in the US. With more than 15 million individuals gaining health insurance through Medicaid expansion, there is an increasing need to understand the implications of this policy within the US cancer population. This review provides an overview of the fundamental principles and nuances of Medicaid expansion, as well as the implications for cancer care.OBSERVATIONS The Patient Protection and Affordable Care Act presented states with an option to expand Medicaid coverage by broadening the eligibility criteria (eg, raising the eligible income level). During the past 10 years, Medicaid expansion has been credited with a 30% reduction in the population of uninsured individuals in the US. Such a significant change in the insurance profile could have important implications for the 1.7 million patients diagnosed with cancer each year, the oncology teams that care for them, and policy makers. However, several factors may complicate efforts to characterize the effect of Medicaid expansion on the US cancer population. Most notably, there is considerable variation among states in terms of whether Medicaid expansion took place, when expansion occurred, eligibility criteria for Medicaid, and coverage types that Medicaid provides. In addition, economic and health policy factors may be intertwined with factors associated with Medicaid expansion. Finally, variability in the manner in which cancer care has been captured and depicted in large databases could affect the interpretation of findings associated with expansion. CONCLUSIONS AND RELEVANCEThe expansion of Medicaid was a historic public policy initiative. To fully leverage this policy to improve oncological care and to maximize learning for subsequent policies, it is critical to understand the effect of Medicaid expansion. This review aims to better prepare investigators and their audiences to fully understand the implications of this important health policy initiative.

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Section: How Expansion Altered Medicaidmentioning

confidence: 99%

Section: Opportunities To Study the Association Of Medicaid Expansion...mentioning

confidence: 99%

Understanding the Implications of Medicaid Expansion for Cancer Care in the US

et al. 2022

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“…This discrepancy elucidates potential disparities in access to care due to LCS coverage being determined at the state level for Medicaid beneficiaries 11,26 . Additional barriers may be in place beyond Medicaid coverage 27 …”

Section: Discussionmentioning

confidence: 92%

“…11,26 Additional barriers may be in place beyond Medicaid coverage. 27 Limited transportation may also be an important consideration in relation to access to care. Our results showed that more non-Hispanic Black individuals who would be eligible for LCS with the 2021 USPSTF recommendation had delayed medical care within the past 12 months compared to non-Hispanic White individuals.…”

Section: Discussionmentioning

confidence: 99%

Impact of U.S. Preventive Services Task Force lung cancer screening update on drivers of disparities in screening eligibility

et al. 2022

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Background:In 2021, the U.S. Preventive Services Task Force (USPSTF) updated its recommendation to expand lung cancer screening (LCS) eligibility and mitigate disparities. Although this increased the number of non-White individuals who are eligible for LCS, the update's impact on drivers of disparities is less clear. This analysis focuses on racial disparities among Black individuals because members of this group disproportionately share late-stage lung cancer diagnoses, despite typically having a lower intensity smoking history compared to non-Hispanic White individuals. Methods:We used data from the National Health Interview Survey to examine the impact of the 2021 eligibility criteria on racial disparities by factors such as education, poverty, employment history, and insurance status. We also examined preventive care use and reasons for delaying medical care.Results: When comparing Black individuals and non-Hispanic White individuals, our analyses show significant differences in who would be eligible for LCS: Those who do not have a high school diploma (28.7% vs. 17.0%, p = 0.002), are in poverty (26.2% vs. 14.9%, p < 0.001), and have not worked in the past 12 months (66.5% vs. 53.9%, p = 0.009). Further, our analyses also show that more Black individuals delayed medical care due to not having transportation (11.1% vs. 3.6%, p < 0.001) compared to non-Hispanic White individuals. Conclusions:Our results suggest that despite increasing the number of Black individuals who are eligible for LCS, the 2021 USPSTF recommendation highlights ongoing socioeconomic disparities that need to be addressed to ensure equitable access.

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Understanding Patient Barriers to Utilization of Low-dose CT Lung Cancer Screening in a High-risk Population

Matsumoto,

Erkmen,

Dako

2024

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Association between Medicaid expansion status and lung cancer screening exam growth: findings from the ACR lung cancer registry

Cited by 3 publications

References 24 publications

Understanding the Implications of Medicaid Expansion for Cancer Care in the US

Understanding the Implications of Medicaid Expansion for Cancer Care in the US

Impact of U.S. Preventive Services Task Force lung cancer screening update on drivers of disparities in screening eligibility

Understanding Patient Barriers to Utilization of Low-dose CT Lung Cancer Screening in a High-risk Population

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