Provider and Organizational Factors Impacting Routine Cancer Screening Among Older Medicaid Enrollees.

Area of Science:

• Public Health
• Health Services Research
• Oncology

Background:

• Cancer screening rates among older adults are crucial for early detection and improved outcomes.
• The COVID-19 pandemic presented significant challenges to routine healthcare, potentially disrupting cancer screening services.
• Understanding how provider and organizational factors influence screening is vital for maintaining access to care.

Purpose of the Study:

• To analyze the association between provider and organizational factors and routine cancer screening for older Medicaid enrollees.
• To compare screening rates before and during the COVID-19 pandemic.
• To identify factors that facilitate or hinder cancer screening in a vulnerable population.

Main Methods:

• Analysis of pre-pandemic (2018/2019) and pandemic (2020/2021) cohorts of New Jersey Medicaid enrollees aged 50-75.
• Utilized linear probability models to assess the influence of provider and organizational characteristics on breast, cervical, colorectal, and lung cancer screening.
• Controlled for enrollee demographics, clinical factors, and geographic variables using linked claims and provider data.

Main Results:

• Higher patient panel sizes were associated with increased screening for breast, cervical, and lung cancers during the pandemic.
• Obstetrician-gynecologist providers were linked to higher breast and cervical cancer screening rates, even during the pandemic.
• Female providers improved screening rates for breast, cervical, and colorectal cancers in female enrollees; older providers (aged 62+) were associated with lower lung cancer screening in 2021.

Conclusions:

• Large group practices effectively maintained breast and cervical cancer screening during the pandemic, with varied results for colorectal and lung cancers.
• Provider gender and specialty significantly impacted cancer screening rates.
• Strategies should focus on supporting large practices and addressing barriers in smaller ones to enhance cancer prevention, particularly during health crises.