Enumerating the Oncology Specialist Workforce in Medicaid: Applying a Triangulated Approach

Area of Science:

• Health Services Research
• Oncology Workforce Analysis
• Health Equity

Background:

• Understanding the oncology specialist workforce serving Medicaid beneficiaries is crucial for equitable cancer care access.
• Existing methods for enumerating specialists are insufficient for detailed analysis of specific oncology subspecialties and their patient populations.

Purpose of the Study:

• To develop and validate a novel methodology for enumerating the oncology specialist workforce within the Medicaid population.
• To describe Medicaid participation rates, patient panel characteristics, and cancer treatment concentrations among various oncology subspecialties.

Main Methods:

• Utilized a multi-source data approach, triangulating taxonomy codes, board certification, and diagnosis codes from Transformed Medicaid Statistical Information System (T-MSIS) claims (2016-2020).
• Employed cluster analysis on International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis patterns to determine cancer site concentration within oncologists' patient panels.
• Included board-certified medical oncologists, radiation oncologists, hematologists, hematologist-oncologists, gynecologic oncologists, and pediatric hematologist-oncologists.

Main Results:

• Approximately 86-89% of oncology specialists participated in Medicaid between 2016 and 2020, with variations by specialty.
• Pediatric hematologist-oncologists' panels showed a higher proportion of Hispanic beneficiaries with cancer (26%).
• Cluster analysis identified specific oncologists with high concentrations of breast cancer (565 medical oncologists, 269 hematologist-oncologists) and hematological cancers (944 hematologist-oncologists).

Conclusions:

• The developed methodology provides a pragmatic approach to assess the oncology workforce available to Medicaid beneficiaries.
• Findings offer baseline data for tracking workforce trends and inform targeted policy strategies to enhance cancer care access.
• This research highlights the need for continued monitoring of specialist participation and patient demographics to address disparities in cancer care.