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.
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.
Medicaid 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.
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.
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.
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
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
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
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
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
Medicaid Reimbursements May Affect Cancer Screening Rates
Among Beneficiaries; Cancer
American Cancer Society
Guidelines for the Early Detection of Cancer