In states that expanded Medicaid eligibility, minority-serving hospitals did not improve average delivery times for cancer treatments, according to research published May 11 in JCO Oncology Practice.
Using the National Cancer Database, researchers from Boston-based Brigham and Women's Hospital examined treatment records for breast, colon, lung and prostate cancer between 2015-16, when more patients became insured under the Affordable Care Act. They compared definitive treatment and time-to-treatment at minority-serving hospitals in states that did and did not expand Medicaid eligibility.
\Within states that expanded Medicaid, the overall proportion of minorities receiving cancer treatment within 30 days increased by 3.62 percent compared to non-expansion states. At the hospital level, however, those that mostly serve minority patients did not improve treatment rates.
"Medicaid expansion under the ACA did not improve receipt of definitive treatment and timeliness of care for patients treated at [minority-serving hospitals,]" said Dan Nguyen, lead study author and a research fellow at the Boston-based hospital. "We need to continue targeting quality improvement at these hospitals, in addition to providing coverage to cancer patients."
The findings suggest more reforms are needed to address cancer care disparities, researchers said.
"Providing people with insurance doesn't necessarily ensure that they will get the care they deserve," said Quoc-Dien Trinh, MD, study co-author and director of ambulatory clinical operations at Brigham and Women's division of urological surgery. "This project reminds stakeholders and policymakers that there's downstream work that has to be done beyond expanding coverage, whether in patient navigation or in making sure that people can afford to miss work to receive care when they need it."