Patients more likely to get breast, colorectal screenings if they have Medicare

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Patients are 50% more likely to get breast cancer screenings, and twice as likely to get colorectal cancer screenings, once they're in the Medicare program, according to new findings published by Epic Research.

Patients are also more likely to be newly diagnosed with lung cancer, breast cancer, colorectal cancer, prostate cancer, hypertension, hyperlipidemia, coronary heart disease, type 2 diabetes, depression and COPD in the year in which they have their first Medicare encounter.

According to the U.S. Department of Health and Human Services, insurance coverage increases the likelihood of a patient visiting their physician, especially in outpatient, primary care settings; since 2010, the Affordable Care Act has required health insurance companies to cover preventative care, such as cancer and chronic disease screenings.

Yet despite these changes, there have only been modest improvements in screening rates for people in private insurance. That's relevant for more than just younger patients – most Americans become eligible for government-subsidized Medicare insurance at age 65, but may not join Medicare right at age 65 if they have private insurance, though they could qualify for coverage earlier due to a disability or other factor.

WHAT'S THE IMPACT?

Looking at cancer screening rates during the year of a patient's first Medicare encounter, researchers found that colorectal cancer screenings nearly doubled when the patient started Medicare coverage, while breast cancer screenings increased by about 50%. These elevated screening rates continued beyond the first year of coverage.

To investigate whether an increase in access to healthcare and screenings resulted in new diagnoses, the team evaluated more than 20,000 patients between the ages of 60 and 70 years old to see whether diagnoses for 14 common conditions occurred with greater frequency when patients had their first Medicare-covered encounter compared to when they were previously uninsured or covered by another insurer. 

They found that initial diagnosis of 10 of the 14 conditions – breast cancer, colorectal cancer, prostate cancer, lung cancer, hypertension, hyperlipidemia, coronary heart disease, type 2 diabetes, depression and COPD – were more commonly diagnosed in the year the patient had their first Medicare encounter than in any of the five years before or after,

Many chronic conditions are diagnosed within the first year of Medicare coverage, and then the initial diagnosis rate for those conditions decreases. This, researchers said, is likely because the most commonly diagnosed conditions in the first year after Medicaid coverage – hyperlipidemia, hypertension, depression, type 2 diabetes and coronary heart disease – all have associated quality measures that are required to be reported to the Centers for Medicare and Medicaid Services.

THE LARGER TREND

In the first year of Medicare coverage, lung, breast, prostate and colorectal cancers were all more likely to be diagnosed. This aligns with previous studies showing a "Medicare effect" on the timing of cancer diagnoses.

Some conditions, like dementia, chronic kidney disease, heart failure and arthritis are more likely to be diagnosed before Medicare coverage takes effect. This might be because these diseases are more likely to have noticeable symptoms that might prompt a patient to seek medical care, authors said.
 

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com