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- Title
The Affordable Care Act's Medicaid Expansion and Impact Along the Cancer-Care Continuum: A Systematic Review.
- Authors
Moss, Haley A; Wu, Jenny; Kaplan, Samantha J; Zafar, S Yousuf
- Abstract
<bold>Background: </bold>Health reform and the merits of Medicaid expansion remain at the top of the legislative agenda, with growing evidence suggesting an impact on cancer care and outcomes. A systematic review was undertaken to assess the association between Medicaid expansion and the goals of the Patient Protection and Affordable Care Act in the context of cancer care. The purpose of this article is to summarize the currently published literature and to determine the effects of Medicaid expansion on outcomes during points along the cancer care continuum.<bold>Methods: </bold>A systematic search for relevant studies was performed in the PubMed/MEDLINE, EMBASE, Scopus, and Cochrane databases. Three independent observers used an abstraction form to code outcomes and perform a quality and risk of bias assessment using predefined criteria.<bold>Results: </bold>A total of 48 studies were identified. The most common outcomes assessed were the impact of Medicaid expansion on insurance coverage (23.4% of studies), followed by evaluation of racial and/or socioeconomic disparities (17.4%) and access to screening (14.5%). Medicaid expansion was associated with increases in coverage for cancer patients and survivors as well as reduced racial- and income-related disparities.<bold>Conclusions: </bold>Medicaid expansion has led to improved access to insurance coverage among cancer patients and survivors, particularly among low-income and minority populations. This review highlights important gaps in the existing oncology literature, including a lack of studies evaluating changes in treatment and access to end-of-life care following implementation of expansion.
- Subjects
UNITED States; MEDICAID; PATIENT Protection &; Affordable Care Act; META-analysis; HEALTH care reform; CANCER survivors; INSURANCE; ECONOMIC impact; HEALTH services accessibility laws; STATISTICS on minorities; INSURANCE law; TUMOR treatment; QUALITY assurance standards; ECONOMIC impact of health care reform; MEDICAID law; PATIENT Protection &; Affordable Care Act -- Economic aspects; FERRANS &; Powers Quality of Life Index; HEALTH services accessibility; TERMINAL care; HEALTH status indicators; CONTINUUM of care; PREVENTIVE health services; SURVIVAL analysis (Biometry); QUALITY assurance; IMPACT of Event Scale; RESEARCH funding; TUMORS; POVERTY; ECONOMICS
- Publication
JNCI: Journal of the National Cancer Institute, 2020, Vol 112, Issue 8, p779
- ISSN
0027-8874
- Publication type
journal article
- DOI
10.1093/jnci/djaa043