In The Literature: Improved Coverage Translates into Imrpoved Outcomes in Young Cancer Patients

The Patient Protection and Affordable Care Act (ACA) will likely improve insurance coverage for most young adults, but subsets of young adults in the United States will face significant premium increases in the individual market. We examined the association between insurance status and cancer-specific outcomes among young adults.
Published Online: June 04, 2014

Methods We used the SEER program to identify 39,447 patients age 20 to 40 years diagnosed with a malignant neoplasm between 2007 and 2009. The association between insurance status and stage at presentation, employment of definitive therapy, and all-cause mortality was assessed using multivariable logistic or Cox regression, as appropriate.

Results Patients who were uninsured were more likely to be younger, male, nonwhite, and unmarried than patients who were insured and were also more likely to be from regions of lower income, education, and population density (P < .001 in all cases). After adjustment for pertinent confounding variables, an association between insurance coverage and decreased likelihood of presentation with metastatic disease (odds ratio [OR], 0.84; 95% CI, 0.75 to 0.94; P = .003), increased receipt of definitive treatment (OR, 1.95; 95% CI, 1.52 to 2.50; P < .001), and decreased death resulting from any cause (hazard ratio, 0.77; 95% CI, 0.65 to 0.91; P = .002) was noted.

Conclusion The improved coverage fostered by the ACA may translate into better outcomes among most young adults with cancer. Extra consideration will need to be given to ensure that patients who will face premium increases in the individual market can obtain insurance coverage under the ACA.


Source: Journal of Clinical Oncology

Recommended Articles
Approximately 70% of all Medicaid beneficiaries receive their healthcare services through managed care, and state Medicaid programs are required to report encounter data to a national database, but 8 states did not during fiscal year 2011, according to a new government report.
ICLIO promises to guide oncologists in community care practices to navigate the growing field of immuno-oncology.
The report found that Medicare Part B spending per beneficiary in 340B hospitals was more than twice that of hospitals outside the program. Groups such as the Community Oncology Alliance have long warned that the 340B program, while essential, has grown beyond its original intent.
Bruce Feinberg, DO; Scott Gottlieb, MD; and Ted Okon, MBA, discuss the recent establishment of the Oncology Care Model by the CMS and compare its structure with the Community Oncology Alliance’s Oncology Medical Home model.
During this segment, the managed care stakeholders discuss drug spending in oncology and its relation to the overall cost of cancer care. Additionally, they consider which stakeholders should work with pharmaceutical companies during the early stages of drug development, and to what degree stakeholders should collaborate with pharma.