Cancer is one of the leading causes of death in U.S. There are disparities in diagnosis, treatment and moreover, lack of insurance coverage may impact the screening and treatment of this deadly disease.
Regular screening tests are important in the detection of breast, cervical, and colorectal (colon) cancers; if detected earlier, then treatment too is likely to work best. These screening tests are known to significantly reduce morbidity and mortality in patients.
AdvertisementMedicaid is a joint state-federal government health insurance program which provides health care coverage for some people with low income, pregnant women, the elderly, and people with disabilities. Medicaid programs may vary across states and over time in eligibility, physician payment, cost-sharing etc.
A study conducted recently found that in states with higher payments by Medicaid for office visits, the beneficiaries were more likely to receive recommended screenings for early detection of all three types of cancers, breast, cervical, and colorectal cancer. However, on the flip side, if the Medicaid beneficiaries had to pay higher amounts for cancer screening tests (such as colonoscopy, mammography and pap smear test), then they were not always linked with increased screenings.
The detailed report of the study is published in the online version of the journal Cancer, which is a peer-reviewed journal of the American Cancer Society. The findings of the study could help the policy makers to identify the barriers to health care access and eventually improve the use of recommended cancer screening services.
In the study, Dr. Michael Halpern, MD, PhD, MPH of RTI International and his colleagues analyzed 2007 Medicaid data from 46 states and Washington DC to determine whether state Medicaid eligibility and reimbursement policies affected receipt of breast, cervical and colorectal cancer screening among Medicaid beneficiaries.
Dr. Halpern, who is a senior fellow and health services and outcomes researcher at RTI commented "Few studies have examined how state-specific differences in Medicaid policies might affect use of preventive care services, particularly for early detection of cancer. Our study was able to compare differences in cancer screening for Medicaid beneficiaries in almost all states, providing a broad, national picture of the effects of state-level Medicaid policies on receipt of these critical medical care services among a large group of underserved individuals."
The researchers found that increased reimbursement for doctor visits positively affected the odds of receiving screening tests, but increases in the 'out-of-pocket' amount for the screening tests by the patients themselves had both positive and negative impacts.
The study experts also found that Medicaid beneficiaries in states that had an "asset test" (note: asset test is a pre-qualifier test which considers an individual's savings, property, or other items of worth to determine whether he or she could enroll in Medicaid) were less likely to be screened for cancer.
Thus, increasing reimbursements for office visits may facilitate access to primary care among Medicaid beneficiaries, and thus raises the likelihood of receiving appropriate cancer screening tests.
Dr. Halpern added "Due to multiple factors, including Health Care Reform and decreased state budgets, many states are changing their Medicaid policies, including how much health care providers are paid and who is allowed to enroll. Our findings can help state health care decision makers and policy leaders to develop new Medicaid policies that aid low income individuals in receiving recommended cancer screenings."
Cancer Screening Guidelines:
Breast cancer: Annual mammograms are recommended starting at age 40. Clinical breast exam should be done every 3 years for women in their 20s and 30s and every year for women 40 and over. If the women have genetic history of breast cancer, then an MRI should be done in addition to a mammogram.
Colorectal cancer and polyps: After the age of 50, some of the recommended tests for colorectal polyps and cancer detection in both men and women are flexible sigmoidoscopy every 5 years or colonoscopy every 10 years.
Cervical cancer: It is recommended that women between ages 21 and 29 should have a Pap smear done every 3 years and women between the ages of 30 and 65 should have a Pap test along with an HPV test (called "co-testing") every 5 years.
General Tips to reduce your Cancer Risk:
• Say no to tobacco.
• Eat plenty of fruits and vegetables and stay healthy.
• Get moving and do regular physical exercises.
• Limit the intake of alcohol if you drink.
• Know your family history and be aware of your risks for certain diseases.
• Do regular body check-ups and cancer screening tests.
Medicaid Reimbursements May Affect Cancer Screening Rates Among Beneficiaries; Cancer Journal
American Cancer Society Guidelines for the Early Detection of Cancer