Impact of Medicaid reimbursement and eligibility policies on receipt of cancer screening.

Authors

null

Michael T. Halpern

RTI International, Washington, DC

Michael T. Halpern , Melissa A. Romaire , Susan G. Haber , Florence K. Tangka , Susan A. Sabatino , David H. Howard

Organizations

RTI International, Washington, DC, RTI International, Research Triangle Park, NC, RTI International, Waltham, MA, Centers for Disease Control and Prevention, DCPC/EARB, Atlanta, GA, Emory University, Department of Health Policy and Management, Atlanta, GA

Research Funding

No funding sources reported

Background: State Medicaid programs cover receipt of cancer screening services. However, coverage of cancer screening tests does not guarantee access to these services. Medicaid beneficiaries are less likely to be screened for cancer and more likely to present with advanced stage cancers. State-specific variations in Medicaid program eligibility requirements and reimbursements for medical services may affect cancer screening rates among Medicaid enrollees. This study examined how eligibility and reimbursement policies affected receipt of breast, cervical, colorectal, and prostate cancer screening. Methods: We examined 2007 Medicaid data for individuals age 21-64 enrolled in fee-for-service Medicaid for at least 4 months from 46 states and the District of Columbia. We examined the association of state-specific Medicaid cancer screening test and office visit reimbursements, income and financial asset eligibility requirements, physician copayments, and frequency of Medicaid eligibility renewal on receipt of cancer screening. Analyses used multivariate logistic regressions with generalized estimating equations to control for correlation between beneficiaries within a state. Results: Increased Medicaid screening test reimbursements were significantly associated with small increases in receipt of colonoscopy, mammograms, and PSA tests. Increased reimbursements for office visits were associated with increased receipt of colonoscopy, FOBT, Pap tests, and mammograms. Greater asset thresholds for Medicaid eligibility increased the likelihood of all screening tests except FOBT. Beneficiaries in states requiring more frequent (<12 month) renewal of Medicaid eligibility were more likely to receive FOBT, PSA, or mammograms, but less likely to receive Pap tests. Conclusions: Increasing Medicaid reimbursement rates and asset policies was generally associated with increases in cancer screening. As proposed Medicaid eligibility expansions will almost certainly increase the number of enrollees in this program, it is crucial to provide adequate reimbursements and develop eligibility policies to promote cancer screening and thereby increase early cancer detection among this underserved population.

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Abstract Details

Meeting

2013 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Health Services Research

Track

Health Services Research

Sub Track

Access to Care

Citation

J Clin Oncol 31, 2013 (suppl; abstr 6514)

DOI

10.1200/jco.2013.31.15_suppl.6514

Abstract #

6514

Poster Bd #

3

Abstract Disclosures

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