Coverage Makes a Difference When It Comes to Surviving Cancer

Coverage Makes a Difference When It Comes to Surviving Cancer


Medi-Cal patients with breast, colon, and rectal cancer are more likely to be diagnosed at an advanced stage of disease and have lower five-year survival rates compared to those with other sources of health insurance, according to a survey by the UC Davis Health System. Medicare-Medi-Cal dual eligible patients are the least likely to get recommended treatment for breast and colon cancer.

VA patients have the longest intervals between diagnosis and treatment for breast, colon, rectal, lung, and prostate cancers, but their treatment outcomes compare favorably to patients with other types of health insurance, and they are generally more likely to get recommended treatment.

Researchers were not surprised that Medi-Cal and Medicare-Medi-Cal dual eligible, and uninsured patients were getting diagnosed at a later stage of cancer and had lower survival rates since adverse social factors affect these populations. But the lower quality of care cannot be as readily explained. In light of the rapid growth of Medi-Cal, the findings highlight the need to investigate the disparities in cancer care, according to the study

Bundled Payment Experiment Fails

bundled payments

California hospitals faced disappointing results in a recent experiment with bundled payments. Researchers at Rand evaluated a pilot program, coordinated by the Integrated Healthcare Association, to adopt bundled payments for orthopedic procedures among commercially insured people under 65. The three-year study began in 2010. Under bundled payments, doctors, hospitals, and other health providers share a fixed payment, which covers the average cost of a bundle of services, such as all aspects of caring for a person undergoing a hip replacement. At the outset, participants included six of the state’s largest health plans, eight hospitals, and an independent practice physicians’ association. Two insurers dropped out, saying that the bundled payment model would not lead to a redesign of care or lower costs. Another said that bundled payment was incompatible with its primary business – HMOs that use capitation payments. Just two hospitals signed contracts with health plans to use bundled payments. However, two ambulatory surgery centers signed contracts with one health plan. The project was hurt by delays in regulatory approval of contracts and a lack of consensus on the types of cases and services to include. Most stakeholders agreed that the bundle definitions were probably too narrow to capture enough procedures to make bundled payment viable. The project had such a low volume of cases that there was not enough information to draw conclusions about how bundled payments affect health care quality or costs, according to researchers. Susan Ridgely of Rand said, “Despite the many challenges, participants continue to be interested in making bundled payments work.” For more information, visit http://www.rand.org/newsletters.html.

Study: Active play just as important in fighting childhood obesity

New Zealand researchers surveyed a group of parents and children in South Auckland and found a large disparity in their perceptions of active play and structured physical activity. The perception that physical activities can be beneficial only when structured appeared to discourage children from participating, according to the study in the New Zealand Medical Journal. The New Zealand Herald (11/9)

Quitting smoking improves survival for lung cancer patients

Researchers looked at the medical records of 4,200 lung cancer patients in the U.S. and found that those ages 84 and younger who had quit smoking more than a year before their diagnosis lived longer than those who continued to smoke. The study appeared online in the journal Cancer. Reuters (10/11)

Researchers: Young children need 3 hours of exercise daily

A commentary in the Archives of Pediatrics & Adolescent Medicine says medical organizations in Australia, the U.K. and the U.S. agree that children younger than 6 should be active for at least three hours a day, spread throughout the day. Researchers said, however, that studies have yet to determine how much physical activity is needed for young children to avoid obesity. MyHealthNewsDaily.com (10/15)

Research measures mortality, diagnostic effect of regular exams

Danish researchers who looked at 16 clinical trials found that general health checkups did not significantly reduce deaths caused by either cardiovascular disorders or cancer. However, they reported in the Cochrane Database of Systematic Reviews an increased number of diagnoses tied to routine checks such as hypertension and hypercholesterolemia. MedPage Today (free registration) (10/16)

Cut cancer with lifestyle changes, researcher says

Lifestyle changes — such as eating a healthy diet, exercising and not smoking — could help prevent more than half of cancer cases, researcher Graham Colditz of the Washington University School of Medicine told a cancer conference. He said being overweight or obese causes about 20% of cancers, but if people maintained a healthy BMI, the rate could be reduced by about half. Medscape (free registration) (9/5)

Last Updated 09/22/2021

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