Effects of Insurance Expansions on Cancer Treatment: Recent Policy Changes and Implications for Future Reform
保险范围扩大对癌症治疗的影响:最近的政策变化以及对未来改革的影响
基本信息
- 批准号:10474355
- 负责人:
- 金额:$ 37.51万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2020
- 资助国家:美国
- 起止时间:2020-09-30 至 2024-09-29
- 项目状态:已结题
- 来源:
- 关键词:
项目摘要
PROJECT SUMMARY/ABSTRACT
Cancer is among the most common causes of death and most costly diseases in the US, and timely access to
high quality treatment is essential for minimizing cancer morbidity and mortality. Insurance coverage is an
important determinant of access to care that contributes to documented disparities in outcomes. The
Affordable Care Act (ACA) expanded access to insurance for non-elderly adults through subsidized
Marketplace coverage and expansion of Medicaid to low-income adults in participating states. There is little
evidence regarding the impact of insurance coverage expansions on access to or quality of cancer care. The
proposed project will leverage variation in the timing of ACA provisions and changes in coverage under those
provisions across geographic areas to estimate the impacts of insurance coverage expansions on cancer
treatment. We use population-based data from Pennsylvania – the largest Medicaid expansion state that did
not have extensive coverage for low-income adults prior to the ACA. Data come from the Pennsylvania state-
wide cancer registry, along with data from all-payer inpatient, hospital outpatient, and ambulatory surgery
center administrative files from the Pennsylvania Health Care Cost Containment Council (PHC4), linked to the
registry at the individual level. The sample includes all non-elderly adult cancer patients in the state, with
discharge information across all payers, including for uninsured patients. We use a quasi-experimental
approach to estimate the effects of both private (Marketplace) and public (Medicaid) expansions on access to
and quality of care for patients diagnosed with the four most common cancers (breast, prostate, lung and
colorectal). Specifically, we examine the impact of insurance expansions on insurance coverage for cancer
patients (Aim 1), access to cancer treatment (Aim 2), and quality of cancer care (Aim 3). We hypothesize that
increases in coverage will be associated with shorter time from diagnosis to treatment; higher likelihood of
treatment in accredited cancer centers, academic centers, and high-volume hospitals; increased receipt of
guideline concordant care; and reductions in hospital readmission. All analysis will be stratified by cancer type,
allowing for assessment of differential impacts across cancers, and we will assess the role of insurance
coverage in reducing disparities in access for racial/ethnic minorities and rural populations. The project will
provide detailed evidence on how the ACA affected insurance coverage, access, and quality of care for cancer
patients, including the impact on existing disparities in care for underserved racial/ethnic minority and rural
patients. A detailed understanding of the impacts of health insurance coverage expansions on care for cancer
(among the most costly and deadly diseases in the US) will inform federal and state policymakers debating
health reform proposals, program officials seeking evidence to guide development and implementation of
coverage and care delivery policies, and researchers assessing ongoing policy changes and interventions to
reduce disparities in cancer care.
项目总结/文摘
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Lindsay Marie Sabik其他文献
Lindsay Marie Sabik的其他文献
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{{ truncateString('Lindsay Marie Sabik', 18)}}的其他基金
Policies to Inform Safe and Equitable Opioid Access for Patients with Advanced Cancer Near End of Life
为临近生命尽头的晚期癌症患者提供安全和公平的阿片类药物使用政策
- 批准号:
10733495 - 财政年份:2023
- 资助金额:
$ 37.51万 - 项目类别:
Effects of Insurance Expansions on Cancer Treatment: Recent Policy Changes and Implications for Future Reform
保险范围扩大对癌症治疗的影响:最近的政策变化以及对未来改革的影响
- 批准号:
10116048 - 财政年份:2020
- 资助金额:
$ 37.51万 - 项目类别:
Effects of Insurance Expansions on Cancer Treatment: Recent Policy Changes and Implications for Future Reform
保险范围扩大对癌症治疗的影响:最近的政策变化以及对未来改革的影响
- 批准号:
10705053 - 财政年份:2020
- 资助金额:
$ 37.51万 - 项目类别:
Impact of Rural Hospital Payment and Delivery Reform on Geographic Disparities in Cancer Surgery
农村医院支付和服务改革对癌症手术地域差异的影响
- 批准号:
10401862 - 财政年份:2020
- 资助金额:
$ 37.51万 - 项目类别:
Effects of Insurance Expansions on Cancer Treatment: Recent Policy Changes and Implications for Future Reform
保险范围扩大对癌症治疗的影响:最近的政策变化以及对未来改革的影响
- 批准号:
10254333 - 财政年份:2020
- 资助金额:
$ 37.51万 - 项目类别:
Impact of Rural Hospital Payment and Delivery Reform on Geographic Disparities in Cancer Surgery
农村医院支付和服务改革对癌症手术地域差异的影响
- 批准号:
10643700 - 财政年份:2020
- 资助金额:
$ 37.51万 - 项目类别:
Impact of Rural Hospital Payment and Delivery Reform on Geographic Disparities in Cancer Surgery
农村医院支付和服务改革对癌症手术地域差异的影响
- 批准号:
10219203 - 财政年份:2020
- 资助金额:
$ 37.51万 - 项目类别:
Disparities in Cancer Screening: The Role of Medicaid Policy
癌症筛查的差异:医疗补助政策的作用
- 批准号:
9064719 - 财政年份:2013
- 资助金额:
$ 37.51万 - 项目类别:
Disparities in Cancer Screening: The Role of Medicaid Policy
癌症筛查的差异:医疗补助政策的作用
- 批准号:
8562222 - 财政年份:2013
- 资助金额:
$ 37.51万 - 项目类别:
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