Consumer / Employer, Payers

Patients Are More Likely To Get Cancer Screenings Once on Medicare, Report Finds

For breast cancer, 20.5% of patients received a screening in the year prior to being on Medicare, compared to 30.4% in the first year of being on Medicare, according to an Epic Research report. For colorectal cancer, screening rates jumped from 6% in the year before being on Medicare to 11% in the first year of being on Medicare.

Medicare, Medicaid, CMS, coverage

Patients are significantly more likely to get cancer screenings once they start Medicare coverage compared to the years prior, a new study shows.

For breast cancer, 20.5% of patients received a screening in the year prior to being on Medicare, compared to 30.4% in the first year of being on Medicare, according to the Epic Research report. For colorectal cancer, screening rates jumped from 6% in the year before being on Medicare to 11% in the first year of being on Medicare. These “elevated screening rates” continued beyond the first year of Medicare coverage as well.

Under the Affordable Care Act, insurance companies are required to cover preventative care like cancer and chronic disease screenings, but increases in screening rates for those covered under private insurance have been “modest,” Epic Research said. Previous research has shown that cancer screenings happen more often at the age of 65, which is likely due to increased insurance coverage through Medicare, the report added.

Epic Research is a research organization led by clinicians and data scientists. Its mission is to share knowledge on medical and public health problems with healthcare professionals. This study analyzed more than 20 million patients between the ages of 60 and 70 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.” 

The study found that 10 out of the 14 conditions were more commonly diagnosed in the first year of having Medicare than in the five years before or after. These conditions are breast cancer, colorectal cancer, prostate cancer, lung cancer, hypertension, hyperlipidemia, coronary heart disease, type 2 diabetes, depression and chronic obstructive pulmonary disease. 

“Many chronic conditions are diagnosed within the first year of Medicare coverage, and then the initial diagnosis rate for those conditions decreases,” Epic Research stated. “This is likely because the most commonly diagnosed conditions in the first year after [Medicare] 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 (CMS). Lung, breast, prostate, and colorectal cancer were all more likely to be diagnosed in the first year of Medicare coverage. This aligns with previous studies showing a ‘Medicare effect’ on the timing of cancer diagnoses.”

The other four conditions — dementia, heart failure, chronic kidney disease and arthritis — were more commonly diagnosed in the five years prior to being covered by Medicare, according to Epic Research.

“This might be because these diseases are more likely to have noticeable symptoms that might prompt a patient to seek medical care,” the study said.

Photo: Vadzim Kushniarou, Getty Images