Racial disparities in timely cancer treatment disappeared in states that expanded Medicaid under the Affordable Care Act (ACA), according to an analysis of over 30,000 health records led by researchers at Yale Cancer Center. The findings were presented today at the American Society of Clinical Oncology (ASCO) 2019 annual meeting.
Prior to Medicaid expansion, the researchers found black adults diagnosed with advanced or metastatic cancer were 4.8 percentage points less likely than white adults to start treatment within 30 days of diagnosis. But in states that expanded Medicaid in 2014 or thereafter, the percentage of black patients receiving timely treatment rose by 6.1 points, from 43.5 percent to 49.6 percent. The researchers note there was also a smaller but less significant improvement of 2.1 percentage points in white patients in those states, from 48.3 percent to 50.3 percent.
The post-expansion difference between the two groups’ access to timely care was less than one percentage point. The results suggest, but do not prove, that Medicaid expansion led to improved health equity, said the researchers.
“The post-expansion difference between the two groups’ access to timely care was no longer statistically significant,” said study author Dr. Amy Davidoff, a senior research scientist at Yale School of Public Health and in Yale Cancer Center’s Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center. “Our results suggest that Medicaid expansion led to improved health equity.”
Dr. Davidoff and Dr. Cary P. Gross, director of COPPER, undertook this research alongside Flatiron Health, an electronic health record company specializing in software and services for oncology providers and in real-world data offerings for researchers.Tags: Friday Letter Submission