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Showing content from https://pubmed.ncbi.nlm.nih.gov/25534387/ below:

Receipt of chemotherapy among medicare patients with cancer by type of supplemental insurance

Observational Study

. 2015 Feb 1;33(4):312-8. doi: 10.1200/JCO.2014.55.3107. Epub 2014 Dec 22. Receipt of chemotherapy among medicare patients with cancer by type of supplemental insurance

Affiliations

¹ Joan L. Warren, Anne-Michelle Noone, and Linda C. Harlan, National Cancer Institute, Bethesda; Jennifer Stevens, Information Management Services, Beltsville, MD; Eboneé N. Butler, University of North Carolina, Chapel Hill, NC; Christopher S. Lathan, Dana-Farber Cancer Institute, Boston, MA; and Kevin Ward, Emory University, Atlanta, GA. joan_warren@nih.gov.
² Joan L. Warren, Anne-Michelle Noone, and Linda C. Harlan, National Cancer Institute, Bethesda; Jennifer Stevens, Information Management Services, Beltsville, MD; Eboneé N. Butler, University of North Carolina, Chapel Hill, NC; Christopher S. Lathan, Dana-Farber Cancer Institute, Boston, MA; and Kevin Ward, Emory University, Atlanta, GA.

PMID: 25534387
PMCID: PMC4302213
DOI: 10.1200/JCO.2014.55.3107

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Observational Study

Receipt of chemotherapy among medicare patients with cancer by type of supplemental insurance

Joan L Warren et al. J Clin Oncol. 2015.

. 2015 Feb 1;33(4):312-8. doi: 10.1200/JCO.2014.55.3107. Epub 2014 Dec 22. Affiliations

¹ Joan L. Warren, Anne-Michelle Noone, and Linda C. Harlan, National Cancer Institute, Bethesda; Jennifer Stevens, Information Management Services, Beltsville, MD; Eboneé N. Butler, University of North Carolina, Chapel Hill, NC; Christopher S. Lathan, Dana-Farber Cancer Institute, Boston, MA; and Kevin Ward, Emory University, Atlanta, GA. joan_warren@nih.gov.
² Joan L. Warren, Anne-Michelle Noone, and Linda C. Harlan, National Cancer Institute, Bethesda; Jennifer Stevens, Information Management Services, Beltsville, MD; Eboneé N. Butler, University of North Carolina, Chapel Hill, NC; Christopher S. Lathan, Dana-Farber Cancer Institute, Boston, MA; and Kevin Ward, Emory University, Atlanta, GA.

PMID: 25534387
PMCID: PMC4302213
DOI: 10.1200/JCO.2014.55.3107

Item in Clipboard

Abstract

Purpose: Medicare beneficiaries with cancer bear a greater portion of their health care costs, because cancer treatment costs have increased. Beneficiaries have supplemental insurance to reduce out-of-pocket costs; those without supplemental insurance may face barriers to care. This study examines the association between type of supplemental insurance coverage and receipt of chemotherapy among Medicare patients with cancer who, per National Comprehensive Cancer Network treatment guidelines, should generally receive chemotherapy.

Patients and methods: This retrospective, observational study included 1,200 Medicare patients diagnosed with incident cancer of the breast (stage IIB to III), colon (stage III), rectum (stage II to III), lung (stage II to IV), or ovary (stage II to IV) from 2000 to 2005. Using the National Cancer Institute Patterns of Care Studies and linked SEER-Medicare data, we determined each Medicare patient's supplemental insurance status (private insurance, dual eligible [ie, Medicare with Medicaid], or no supplemental insurance), consultation with an oncologist, and receipt of chemotherapy. Using adjusted logistic regression, we evaluated the association of type of supplemental insurance with oncologist consultation and receipt of chemotherapy.

Results: Dual-eligible patients were significantly less likely to receive chemotherapy than were Medicare patients with private insurance. Patients with Medicare only who saw an oncologist had comparable rates of chemotherapy compared with Medicare patients with private insurance.

Conclusion: Dual-eligible Medicare beneficiaries received recommended cancer chemotherapy less frequently than other Medicare beneficiaries. With the increasing number of Medicaid patients under the Affordable Care Act, there will be a need for patient navigators and sufficient physician reimbursement so that low-income patients with cancer will have access to oncologists and needed treatment.

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Conflict of interest statement

Authors' disclosures of potential conflicts of interest are found in the article online at www.jco.org . Author contributions are found at the end of this article.

Figures
Fig 1.

Steps to determine if Medicare…

Fig 1.

Steps to determine if Medicare beneficiaries had private insurance or Medicaid. FFS, fee…

Fig 1.

Steps to determine if Medicare beneficiaries had private insurance or Medicaid. FFS, fee for service; MSP, Medicare is secondary payer to private insurance; POC, Patterns of Care; SBI, state buy-in.