Cancer patients with Medi-Cal are less likely to get recommended treatment and also have lower survival rates than patients with other types of insurance, according to a study by UC Davis researchers. Medi-Cal is California's version of Medicaid, health insurance for people who are low income.
While other studies have linked Medicaid insurance status to worse cancer outcomes, the UC Davis study appears to be the first to examine the impact of various kinds of health insurance across more than one kind of cancer.
Understanding how well Medi-Cal serves cancer patients is crucial, experts say, because as much as 10 percent of Medi-Cal expenditures go to cancer care. And under the Affordable Care Act, the program has grown to cover more than 12 million Californians – nearly a third of the state’s population.
“What’s striking is how similar the findings were for Medi-Cal members and the uninsured,” said Dr. Kenneth Kizer, director of the UC Davis’ Institute for Population Health Improvement, which conducted the study. “If we weren’t spending billions of Medi-Cal dollars on cancer care perhaps that would not be surprising, but you’d think that the outcomes might be better when you’re spending that much money.”
The UC Davis researchers used California Cancer Registry data to study the experiences of approximately 700,000 Californians diagnosed with breast, colon, rectal, lung, and prostate cancer between 2004 and 2012. They tracked how early these patients were diagnosed, their quality of treatment and their five-year relative survival rates according to their type of insurance. The types were Medi-Cal, Medicare, dual Medi-Cal/Medicare (for lowest-income seniors), private insurance, Department of Defense (DOD) insurance and Department of Veterans Affairs (VA) insurance.