Evidence map›Paper›PMID 38958003›Full record

ArticleHealth services research2024

Effects of Medicaid managed care on early detection of cancer: Evidence from mandatory Medicaid managed care program in Pennsylvania.

Youngmin Kwon, Eric T Roberts, Evan S Cole, Howard B Degenholtz, Bruce L Jacobs, Lindsay M Sabik

Abstract read
In one paragraph

Article in Health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Youngmin KwonDepartment of Health Policy & Management, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA.ORCID 0000-0001-8037-5758
Eric T RobertsDepartment of General Internal Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0002-7439-0799
Evan S ColeDepartment of Health Policy & Management, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA.
Howard B DegenholtzDepartment of Health Policy & Management, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA.
Bruce L JacobsDepartment of Urology, Division of Health Services Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.ORCID 0000-0003-1358-0764
Lindsay M SabikDepartment of Health Policy & Management, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA.ORCID 0000-0002-0613-4929

Funding

Access to care for older cancer survivors: Impacts of Medicare and supplemental insurance coverageR36HS029262 · AHRQ · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI KWON, YOUNGMIN · 2023 to 2023
$43k
Agency for Healthcare Research and Quality R36HS029262-01A1AHRQ HHS R36 HS029262
6 · The paper itself

Abstract

objectiveTo examine changes in late- versus early-stage diagnosis of cancer associated with the introduction of mandatory Medicaid managed care (MMC) in Pennsylvania. DATA SOURCES AND STUDY

settingWe analyzed data from the Pennsylvania cancer registry (2010-2018) for adult Medicaid beneficiaries aged 21-64 newly diagnosed with a solid tumor. To ascertain Medicaid and managed care status around diagnosis, we linked the cancer registry to statewide hospital-based facility records collected by an independent state agency (Pennsylvania Health Care Cost Containment Council). STUDY

designWe leveraged a natural experiment arising from county-level variation in mandatory MMC in Pennsylvania. Using a stacked difference-in-differences design, we compared changes in the probability of late-stage cancer diagnosis among those residing in counties that newly transitioned to mandatory managed care to contemporaneous changes among those in counties with mature MMC programs. DATA COLLECTION/EXTRACTION

methodsN/A. PRINCIPAL

findingsMandatory MMC was associated with a reduced probability of late-stage cancer diagnosis (-3.9 percentage points; 95% CI: -7.2, -0.5; p = 0.02), particularly for screening-amenable cancers (-5.5 percentage points; 95% CI: -10.4, -0.6; p = 0.03). We found no significant changes in late-stage diagnosis among non-screening amenable cancers.

conclusionsIn Pennsylvania, the implementation of mandatory MMC for adult Medicaid beneficiaries was associated with earlier stage of diagnosis among newly diagnosed cancer patients with Medicaid, especially those diagnosed with screening-amenable cancers. Considering that over half of the sample was diagnosed with late-stage cancer even after the transition to mandatory MMC, Medicaid programs and managed care organizations should continue to carefully monitor receipt of cancer screening and design strategies to reduce barriers to guideline-concordant screening or diagnostic procedures.

Indexed as

Early Detection of CancerManaged Care ProgramsMedicaidNeoplasmsAdultFemaleHumansMaleMandatory ProgramsMiddle AgedPennsylvaniaUnited StatesYoung Adultcancer early detectioncancer staginghealthcare disparitieshealth services accessibilitymanaged caremedicaidnational program of cancer registries

Identifiers

PMID38958003
PMCPMC11366964

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.