ASCO Calls for Medicaid Reform to Improve Cancer Care for Low-Income Americans

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ASCO issued a new policy statement that outlines 9 recommendations to reform Medicaid for low-income patients.
ASCO issued a new policy statement that outlines 9 recommendations to reform Medicaid for low-income patients.

Spotlighting disparities in access to care and the quality of care among low-income Americans diagnosed with cancer, the American Society of Clinical Oncology (ASCO) has issued a new call for key reforms to the Medicaid health insurance program.

The American Society of Clinical Oncology (ASCO) is calling for major Medicaid reform to improve access to cancer screening and treatment for low-income patients.1

"Millions of Americans who rely on Medicaid won't be able to take advantage of advances in cancer prevention and treatment unless meaningful reform occurs," warned ASCO President Peter Paul Yu, MD, FACP, FASCO, in his announcement of the new policy statement, which was published on Monday in the Journal of Clinical Oncology (Table).

Table. ASCO's Policy Statement on Medicaid Reform1 Policy Recommendations
1. Expansion of availability for Medicaid coverage to all people with incomes below the federal poverty level, in all 50 states.
2. Oral drug parity with intravenous drug copay and out-of-pocket cost sharing for patients with Medicaid insurance.
3. Extend clinical trial protections to patients with Medicaid insurance, including the right to cross state lines to participate in clinical trials.
4. Elimination of copays and other “artificial barriers” to cancer screening and diagnostic follow-up for all Medicaid patients.
5. Require coverage of genetic testing without deductibles or copays, for patients at high risk for heritable cancer risk.
6. Improve the Medicaid 340B hospital drug pricing discount program.
7. Eliminate differences between Medicare and Medicaid physician payment rates for cancer care. (Medicaid rates tend to be lower.)
8. Adopt quality-of-care standards for all states. (”ASCO believes that states should continue to have the autonomy to run their own Medicaid programs, but should be required to meet specific quality standards; otherwise, the federal government should intervene to improve the quality of care,” the authors explained.)
9. Allow oncology practices to be designated as medical homes and expand reimbursement for care coordination and patient education.

Approximately 68 million Americans are currently enrolled in Medicaid, including 2.1 million who have had cancer diagnoses. But copay provisions and other barriers are impeding their access to high-quality screening and cancer care, Dr. Yu cautioned.

RELATED: Medicaid Reimbursement Linked with Greater Cancer Screening Rate

Worse yet, not all low-income Americans who would be eligible for Medicaid have been enrolled in the program, in part because some states have refused to participate in the Affordable Care Act's Medicaid expansion.

“Currently, 27 states plus the District of Columbia have expanded their Medicaid programs while 23 states have not,” noted coauthor Blase N. Polite, MD, of the University of Chicago in Chicago, IL.

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