Comparing quality of care for Medicaid and commercially insured patients with cancer in Washington State.

Authors

null

Catherine R. Fedorenko

Fred Hutchinson Cancer Research Center, Seattle, WA

Catherine R. Fedorenko, Laura Elizabeth Panattoni, Julia Rose Walker, Li Li, Karma L. Kreizenbeck, Scott David Ramsey

Organizations

Fred Hutchinson Cancer Research Center, Seattle, WA

Research Funding

Other

Background: Uniformity in receipt of high quality cancer care is imperative to reduce health care disparities. In order to help prioritize efforts aimed at reducing disparities in care, we compared several quality metrics for Washington State cancer patients enrolled in Medicaid and commercial insurance plans. Methods: We linked 2014-2016 Washington state cancer registry records for cancer patients under the age of 65 with enrollment and claims records for the two largest commercial insurers in the state and Medicaid. We then generated thirteen nationally recognized quality measures. Outcome measures were adjusted for age, sex, comorbidity score, stage, cancer site, and treatment factors where appropriate. Process measures were not adjusted. Results: 6,868 commercially insured and 2,379 Medicaid patients are represented in the reported quality measures. Conclusions: Care of Washington state cancer patients enrolled in Medicaid is comparable or superior to commercially insured patients, except for significantly higher ED use during chemotherapy. Further research is needed to understand why Medicaid-enrolled cancer patients utilize the ED at more than double the rate of commercially insured patients.

MeasureTumor SiteCommercialMedicaidp-value
Recommended treatmentBreast, lung, colorectal92%89%
Breast93%90%
Anti-nausea meds during chemotherapyBreast, lung, colorectal98%99%
Breast98%99%
Emergency department visits during chemotherapy*All except leukemia21%43%p < 0.001
Inpatient stays during chemotherapy*All except leukemia27%34%
Advanced imaging after treatmentBreast, lung, colon14%17%
Breast15%25%p = 0.04
Tumor marking testing after treatmentBreast30%24%
End of Life (EoL): ChemotherapySolid10%9%
EoL: 2+ ED visits*Solid16%21%
EoL: ICU stay*Solid26%22%p = 0.04
EoL: HospiceSolid38%43%p = 0.04

* Outcome measure

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2018 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session A: Big Data Studies; Projects Relating to Equity, Value, and Policy

Track

Projects Relating to Equity, Value and Policy,Big Data Studies

Sub Track

Health Disparities

Citation

J Clin Oncol 36, 2018 (suppl 30; abstr 75)

DOI

10.1200/JCO.2018.36.30_suppl.75

Abstract #

75

Poster Bd #

H4

Abstract Disclosures

Similar Abstracts

Abstract

2020 ASCO Virtual Scientific Program

Reliability and correlations among quality measures for lung, breast, and colorectal cancer.

First Author: Jessica Cleveland

Abstract

2023 ASCO Quality Care Symposium

Multidisciplinary education and action to foster equitable cancer care.

First Author: Monica Augustyniak

Abstract

2023 ASCO Quality Care Symposium

Quality of colorectal and anal cancer care delivered during the COVID pandemic.

First Author: Melanie Lynn Powis