Cancer patients with Medicaid coverage receive poorer quality and less healthcare than those with employer-sponsored, Medicare or other private insurance.
A survey of cancer patients by the not-for-profit Cancer Support Community found that Medicaid beneficiaries with cancer more often felt their doctors rushed through their appointments, more likely experienced delays in getting appointments, were the least likely to receive social and emotional support services, and more likely to say they only “sometimes” got the coverage they needed compared with other individuals.
One key reason for the disparity is that Medicaid benefits vary from state by state and experts say that inequality is likely to grow under strategies proposed by the Trump administration.
“A fix would be to create some level of required standardization of care across states, but that would be tough,” said Linda House, president of Cancer Support Community.
Both President-Elect Donald Trump and Republican leaders want to give states even more authority to determine how to spend their Medicaid dollars. The GOP wants to turn Medicaid to either a block grant or per-beneficiary cap system against the wishes of many policymakers. States could then decide what and who their program covers and allow them to make cuts to Medicaid spending.
House thinks there is promise in Medicare's Oncology Care Model which launched this year. The demo pays providers to better manage care for cancer patients or else risk a financial penalty. Seventeen private health insurance companies and more than 3,200 oncologists working in almost 200 medical groups have signed up.
Dr. David Beyer, a radiation oncologist and medical director of Cancer Centers of Northern Arizona at Sedona, says Medicare patients benefit from notably different patient care because they aren't subject to the same prior authorization as Medicaid patients.
“I think they erroneously conclude the best way to stop abuse, is to delay the care people need,” Beyer said. “Somebody thinks this is a way to save money.”
Dr. Michael Halpern, associate professor of health services administration and policy at Temple University College of Public Health, believes Medicaid patients would receive better care if oncology providers were paid better Medicaid rates.
Halpern released a paper this year that found Medicaid beneficiaries with breast cancer received surgery sooner if they lived in states with higher reimbursement rates.
