State Medicaid Programs Result in Survival Differences in Head and Neck Cancer

Among patients with head and neck cancer who receive Medicaid, different factors appear to contribute to overall survival. These results were recently published in the JAMA Otolaryngology Head Neck Surgery.

Medicaid is a government-subsidized form of insurance, the beneficiaries of which are typically low income. Being government-subsidized, treatment covered for each condition may be less comprehensive than for those of private insurances; however, this may not always be the case. Furthermore, some physicians will not accept patients on Medicaid, as their reimbursement for services may be significantly lower compared to reimbursement from other types of insurance carriers.

In an attempt to provide optimal outcomes for all patients, researchers are trying to identify possible variables that may be associated with poorer outcomes for individuals on Medicaid. The hope is that identification of these variables may potentially lead to their change so that every patient has a chance for optimal outcomes.

Researchers recently evaluated data from Medicaid claims from cancer registry data from California and Georgia. The data included 1,308 patients between 18 and 64 years of age with head and neck cancer. The included claims were from 2002 to 2006.

Among patients who survived at least one year, those in California had only half the risk of death than those in Georgia at two years following diagnosis.
Fewer than one-third of patients received their diagnosis when their cancer was in early stages.
Black patients were less likely to receive surgery and more likely to die from the disease than white patients.
Older patients and those with disabilities also had a significant increase in death rates at one year following their diagnosis.
The researchers concluded that “Further research is needed to explore the state-level policies and attributes to examine the startling differences in mortality among the state Medicaid programs analyzed in this study.” Furthermore, reasons for racial, age and disability disparities in outcomes should be further explored among those with head and neck cancer who receive Medicaid.

Reference: Subramanian S, Chen A. Treatment Patterns and Survival among Low-Income Medicaid Patients with Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg. 2013;():1-7. doi:10.1001/jamaoto.2013.2549.