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Assessing Community Cancer care after insurance ExpanSionS (ACCESS) study protocol.

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The Affordable Care Act (ACA) Medicaid expansion improved access to cancer prevention services for vulnerable populations. This study assesses its impact on cancer care and screening, crucial for reducing mortality.

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Area of Science:

  • Public Health
  • Health Services Research
  • Cancer Prevention

Background:

  • Cancer remains a leading cause of death in the US, with screening and prevention improving survival rates.
  • Vulnerable populations face disparities in cancer care access and outcomes compared to insured, non-Hispanic white populations.
  • The Affordable Care Act (ACA) expanded Medicaid eligibility, creating a natural experiment to study its effect on cancer prevention and care.

Purpose of the Study:

  • To evaluate the impact of Medicaid expansion on cancer prevention services and healthcare delivery.
  • To compare cancer screening and preventive care receipt between different patient populations post-Medicaid expansion.

Main Methods:

  • Utilizing electronic health record data from 990 community health centers.
  • Analyzing data up to 24 months pre- and at least one year post-Medicaid expansion.
  • Primary outcomes: insurance status; Additional outcomes: healthcare encounters and cancer prevention/screening service receipt.

Main Results:

  • Uninsured patients receive fewer recommended cancer screening and prevention services compared to insured patients.
  • Medicaid expansion is anticipated to improve access to these vital services for vulnerable groups.
  • The study will provide insights into cancer-related healthcare service utilization and disparities.

Conclusions:

  • Cancer screening and prevention are vital for reducing morbidity and mortality.
  • This natural policy experiment offers critical data on healthcare resource allocation and health reform.
  • Understanding the impact of Medicaid expansion is key to addressing cancer care disparities.