Cancer Screenings More Prominent in States with Higher Medicaid Reimbursements

Medicaid beneficiaries are more likely to be screened for 3 types of cancer in states where physicians receive higher payments for office visits, a study suggests.

Medicaid beneficiaries have a better chance to be screened for breast, cervical, and colorectal cancer if they live in a state with higher Medicaid payments for office visits.

According to a study published online August 25, 2014 in CANCER, the peer-reviewed journal of the American Cancer Society, higher reimbursement rates for Medicaid office visits were consistently associated with the likelihood of receiving screening tests for early cancer detection. Researchers analyzed 2007 Medicaid data from 46 states and the District of Columbia for patients aged 21 to 64 who had been enrolled in a fee-for-service Medicaid for more than 4 months.

“Few studies have examined how state-specific differences in Medicaid policies might affect use of preventive care services, particularly for early detection of cancer,” Michael Halpern, MD, the study’s lead author, said in a press release. “Our study was able to compare differences in cancer screening for Medicaid beneficiaries in almost all states, providing a broad, national picture of the effects of state-level Medicaid policies on receipt of these critical medical care services among a large group of underserved individuals.”

Despite this, higher payments for the cancer tests themselves were not always linked with increased screening rates. The researchers included colonoscopy, mammography, and Pap tests in their analysis.

In addition, Medicaid beneficiaries in states with an “asset test,” which considers savings, property, and other items of worth to determine Medicaid eligibility, were less likely to be screened for cancer. The findings may reflect barriers in health care access for patients in states with lower Medicaid reimbursement rates, the research notes. A solution to the problem is more elusive, however.

Although increasing reimbursement rates for office visits may increase access, and therefore increase the likelihood of receiving a screening test, raising the reimbursement rates might not be an effective policy tool for increasing use of recommended screenings. In addition, eliminating asset tests may increase the likelihood of receiving cancer screenings, by allowing more low-income individuals to remain in Medicaid.

“Due to multiple factors, including Health Care Reform and decreased state budgets, many states are changing their Medicaid policies, including how much health care providers are paid and who is allowed to enroll,” Dr. Halpern said. “Our findings can help state health care decision makers and policy leaders to develop new Medicaid polices that aid low income individuals in receiving recommended cancer screenings.”