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

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

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Although state Medicaid programs cover cancer screening, Medicaid beneficiaries are less likely to be screened for cancer and are more likely to present with tumors of an advanced stage than are those with other insurance. The current study was performed to determine whether state Medicaid eligibility and reimbursement policies affect the receipt of breast, cervical, and colon cancer screening among Medicaid beneficiaries. Cross-sectional regression analyses of 2007 Medicaid data from 46 states and the District of Columbia were performed to examine associations between state-specific Medicaid reimbursement/eligibility policies and receipt of cancer screening. The study sample included individuals aged 21 years to 64 years who were enrolled in fee-for-service Medicaid for at least 4 months. Subsamples eligible for each screening test were: Papanicolaou test among 2,136,511 patients, mammography among 792,470 patients, colonoscopy among 769,729 patients, and fecal occult blood test among 753,868 patients. State-specific Medicaid variables included median screening test reimbursement, income/financial asset eligibility requirements, physician copayments, and frequency of eligibility renewal. Increases in screening test reimbursement demonstrated mixed associations (positive and negative) with the likelihood of receiving screening tests among Medicaid beneficiaries. In contrast, increased reimbursements for office visits were found to be positively associated with the odds of receiving all screening tests examined, including colonoscopy (odds ratio [OR], 1.07; 95% confidence interval [95% CI], 1.06-1.08), fecal occult blood test (OR, 1.09; 95% CI, 1.08-1.10), Papanicolaou test (OR, 1.02; 95% CI, 1.02-1.03), and mammography (OR, 1.02; 95% CI, 1.02-1.03). Effects of other state-specific Medicaid policies varied across the screening tests examined. Increased reimbursement for office visits was consistently associated with an increased likelihood of being screened for cancer, and may be an important policy tool for increasing screening among this vulnerable population.

Original languageEnglish (US)
Pages (from-to)3016-3024
Number of pages9
JournalCancer
Volume120
Issue number19
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Medicaid
Early Detection of Cancer
Odds Ratio
Confidence Intervals
Papanicolaou Test
Office Visits
Occult Blood
Hematologic Tests
Mammography
Colonoscopy
Fee-for-Service Plans
Neoplasms
Vulnerable Populations
Insurance
Uterine Cervical Neoplasms
Colonic Neoplasms
Cross-Sectional Studies
Regression Analysis
Breast Neoplasms
Physicians

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Halpern, M., Romaire, M. A., Haber, S. G., Tangka, F. K., Sabatino, S. A., & Howard, D. H. (2014). Impact of state-specific Medicaid reimbursement and eligibility policies on receipt of cancer screening. Cancer, 120(19), 3016-3024. https://doi.org/10.1002/cncr.28704

Impact of state-specific Medicaid reimbursement and eligibility policies on receipt of cancer screening. / Halpern, Michael; Romaire, Melissa A.; Haber, Susan G.; Tangka, Florence K.; Sabatino, Susan A.; Howard, David H.

In: Cancer, Vol. 120, No. 19, 2014, p. 3016-3024.

Research output: Contribution to journalArticle

Halpern, M, Romaire, MA, Haber, SG, Tangka, FK, Sabatino, SA & Howard, DH 2014, 'Impact of state-specific Medicaid reimbursement and eligibility policies on receipt of cancer screening.', Cancer, vol. 120, no. 19, pp. 3016-3024. https://doi.org/10.1002/cncr.28704
Halpern, Michael ; Romaire, Melissa A. ; Haber, Susan G. ; Tangka, Florence K. ; Sabatino, Susan A. ; Howard, David H. / Impact of state-specific Medicaid reimbursement and eligibility policies on receipt of cancer screening. In: Cancer. 2014 ; Vol. 120, No. 19. pp. 3016-3024.
@article{398f11435c1f4503af5b3b15a6e9350d,
title = "Impact of state-specific Medicaid reimbursement and eligibility policies on receipt of cancer screening.",
abstract = "Although state Medicaid programs cover cancer screening, Medicaid beneficiaries are less likely to be screened for cancer and are more likely to present with tumors of an advanced stage than are those with other insurance. The current study was performed to determine whether state Medicaid eligibility and reimbursement policies affect the receipt of breast, cervical, and colon cancer screening among Medicaid beneficiaries. Cross-sectional regression analyses of 2007 Medicaid data from 46 states and the District of Columbia were performed to examine associations between state-specific Medicaid reimbursement/eligibility policies and receipt of cancer screening. The study sample included individuals aged 21 years to 64 years who were enrolled in fee-for-service Medicaid for at least 4 months. Subsamples eligible for each screening test were: Papanicolaou test among 2,136,511 patients, mammography among 792,470 patients, colonoscopy among 769,729 patients, and fecal occult blood test among 753,868 patients. State-specific Medicaid variables included median screening test reimbursement, income/financial asset eligibility requirements, physician copayments, and frequency of eligibility renewal. Increases in screening test reimbursement demonstrated mixed associations (positive and negative) with the likelihood of receiving screening tests among Medicaid beneficiaries. In contrast, increased reimbursements for office visits were found to be positively associated with the odds of receiving all screening tests examined, including colonoscopy (odds ratio [OR], 1.07; 95{\%} confidence interval [95{\%} CI], 1.06-1.08), fecal occult blood test (OR, 1.09; 95{\%} CI, 1.08-1.10), Papanicolaou test (OR, 1.02; 95{\%} CI, 1.02-1.03), and mammography (OR, 1.02; 95{\%} CI, 1.02-1.03). Effects of other state-specific Medicaid policies varied across the screening tests examined. Increased reimbursement for office visits was consistently associated with an increased likelihood of being screened for cancer, and may be an important policy tool for increasing screening among this vulnerable population.",
author = "Michael Halpern and Romaire, {Melissa A.} and Haber, {Susan G.} and Tangka, {Florence K.} and Sabatino, {Susan A.} and Howard, {David H.}",
year = "2014",
doi = "10.1002/cncr.28704",
language = "English (US)",
volume = "120",
pages = "3016--3024",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "19",

}

TY - JOUR

T1 - Impact of state-specific Medicaid reimbursement and eligibility policies on receipt of cancer screening.

AU - Halpern, Michael

AU - Romaire, Melissa A.

AU - Haber, Susan G.

AU - Tangka, Florence K.

AU - Sabatino, Susan A.

AU - Howard, David H.

PY - 2014

Y1 - 2014

N2 - Although state Medicaid programs cover cancer screening, Medicaid beneficiaries are less likely to be screened for cancer and are more likely to present with tumors of an advanced stage than are those with other insurance. The current study was performed to determine whether state Medicaid eligibility and reimbursement policies affect the receipt of breast, cervical, and colon cancer screening among Medicaid beneficiaries. Cross-sectional regression analyses of 2007 Medicaid data from 46 states and the District of Columbia were performed to examine associations between state-specific Medicaid reimbursement/eligibility policies and receipt of cancer screening. The study sample included individuals aged 21 years to 64 years who were enrolled in fee-for-service Medicaid for at least 4 months. Subsamples eligible for each screening test were: Papanicolaou test among 2,136,511 patients, mammography among 792,470 patients, colonoscopy among 769,729 patients, and fecal occult blood test among 753,868 patients. State-specific Medicaid variables included median screening test reimbursement, income/financial asset eligibility requirements, physician copayments, and frequency of eligibility renewal. Increases in screening test reimbursement demonstrated mixed associations (positive and negative) with the likelihood of receiving screening tests among Medicaid beneficiaries. In contrast, increased reimbursements for office visits were found to be positively associated with the odds of receiving all screening tests examined, including colonoscopy (odds ratio [OR], 1.07; 95% confidence interval [95% CI], 1.06-1.08), fecal occult blood test (OR, 1.09; 95% CI, 1.08-1.10), Papanicolaou test (OR, 1.02; 95% CI, 1.02-1.03), and mammography (OR, 1.02; 95% CI, 1.02-1.03). Effects of other state-specific Medicaid policies varied across the screening tests examined. Increased reimbursement for office visits was consistently associated with an increased likelihood of being screened for cancer, and may be an important policy tool for increasing screening among this vulnerable population.

AB - Although state Medicaid programs cover cancer screening, Medicaid beneficiaries are less likely to be screened for cancer and are more likely to present with tumors of an advanced stage than are those with other insurance. The current study was performed to determine whether state Medicaid eligibility and reimbursement policies affect the receipt of breast, cervical, and colon cancer screening among Medicaid beneficiaries. Cross-sectional regression analyses of 2007 Medicaid data from 46 states and the District of Columbia were performed to examine associations between state-specific Medicaid reimbursement/eligibility policies and receipt of cancer screening. The study sample included individuals aged 21 years to 64 years who were enrolled in fee-for-service Medicaid for at least 4 months. Subsamples eligible for each screening test were: Papanicolaou test among 2,136,511 patients, mammography among 792,470 patients, colonoscopy among 769,729 patients, and fecal occult blood test among 753,868 patients. State-specific Medicaid variables included median screening test reimbursement, income/financial asset eligibility requirements, physician copayments, and frequency of eligibility renewal. Increases in screening test reimbursement demonstrated mixed associations (positive and negative) with the likelihood of receiving screening tests among Medicaid beneficiaries. In contrast, increased reimbursements for office visits were found to be positively associated with the odds of receiving all screening tests examined, including colonoscopy (odds ratio [OR], 1.07; 95% confidence interval [95% CI], 1.06-1.08), fecal occult blood test (OR, 1.09; 95% CI, 1.08-1.10), Papanicolaou test (OR, 1.02; 95% CI, 1.02-1.03), and mammography (OR, 1.02; 95% CI, 1.02-1.03). Effects of other state-specific Medicaid policies varied across the screening tests examined. Increased reimbursement for office visits was consistently associated with an increased likelihood of being screened for cancer, and may be an important policy tool for increasing screening among this vulnerable population.

UR - http://www.scopus.com/inward/record.url?scp=84908505260&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84908505260&partnerID=8YFLogxK

U2 - 10.1002/cncr.28704

DO - 10.1002/cncr.28704

M3 - Article

VL - 120

SP - 3016

EP - 3024

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 19

ER -