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No change in receipt of definitive care reported for minorities in expansion states versus nonexpansion states.

For patients with cancer, Medicaid expansion is not associated with improved care at minority-serving hospitals (MSHs), according to a study published online May 11 in JCO Oncology Practice.

David-Dan Nguyen, M.P.H., from Brigham and Women’s Hospital in Boston, and colleagues conducted a retrospective, difference-in-differences (DID) study involving patients with nonmetastatic breast, colon, non-small cell lung, and prostate cancer between the ages of 40 and 64 years. Non-Hispanic Black and Hispanic patients were defined as racial/ethnic minorities. The effect of Medicaid expansion was examined on receipt of stage-appropriate definitive therapy, time-to-treatment initiation (TTI) within 30 days of diagnosis, and TTI within 90 days of diagnosis.

The researchers observed no change in receipt of definitive treatment for minorities in expansion states compared with minorities in nonexpansion states. There was an increase noted in the proportion of racial/ethnic minorities in expansion states receiving treatment within 30 days compared with minority patients in nonexpansion states (DID, +3.62 percent); for TTI within 90 days, no change was observed. Similar results were seen in an analysis focusing on Black cancer patients. In analyses stratified by MSH status, when comparing MSHs in expansion versus nonexpansion states, there was no change in receipt of definitive therapy, TTI within 30 days, and TTI within 90 days.

“We need to continue improving care at the facility level and continue targeting quality improvement at these hospitals, in addition to providing coverage to cancer patients,” Nguyen said in a statement.

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One author disclosed financial ties to the pharmaceutical industry.

Abstract/Full Text