NCPA - National Center for Policy Analysis

Cancer Survival Rates by Medicaid Status

January 16, 2012

Cancer patients on Medicaid survive less time after their diagnosis than people with private or no insurance, data from Ohio show.  Dr. Derek Raghavan and colleagues looked at eight different cancers in patients from an Ohio cancer registry.  Spanning thousands of patients cases, the research team focused on survival rates after five years -- five years is a normal metric given that the cancers in question are curable and should therefore confer five more years of life.

  • The new study, published in the journal Cancer, tracked more than 11,000 patients with private or no insurance and 1,345 Medicaid beneficiaries, half of whom enrolled after or around the time they got their diagnosis.
  • Of the non-Medicaid patients, fewer than one in 10 died within five years of their cancer diagnosis.
  • By comparison, more than one in five Medicaid patients died during that period, and those who enrolled in Medicaid later survived the shortest time.
  • The overall conclusion, following this data, was that Medicaid enrollees were between 1.6 and 2.4 times as likely as other patients to die of their disease within five years.

The gap between patients who were already on Medicaid and those who enrolled after being diagnosed has legitimate theories to explain it.  One such theory is that for those patients who have been on Medicaid for some time, a certain degree of know-how has already been obtained in gaining access to specialists and cutting through red tape.

Nonetheless, the larger, more significant gap between Medicaid enrollees and private-sector patients has been much more difficult to explain.  Dr. Karin Rhodes, who directs the Division of Health Policy Research at the University of Pennsylvania School of Medicine in Philadelphia, has suggested that a primary reason has to do with lack of access to screening and preventative care.  Pointing to reimbursement rates, she argues that physicians are quicker to accept appointments from private-sector enrollees who will likely pay more.  This exclusiveness limits preventative care for Medicaid enrollees and contributes to their higher fatality rate.

Source: Frederik Joelving, "Ohio Medicaid Cancer Patients Survive Less Time," Reuters, December 30, 2011.  Siran M. Koroukian, Paul M. Bakaki and Derek Raghavan, "Survival Disparities by Medicaid Status," Cancer, December 27, 2011.

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