Findings from City of Hope National Medical Center in Cancer Reported (Medicare Advantage Networks and Access To High-volume Cancer Surgery Hospitals): Cancer

2021 NOV 25 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Research findings on Cancer are discussed in a new report. According to news reporting out of Duarte, California, by NewsRx editors, research stated, “To determine how Medicare Advantage (MA) health plan networks impact access to high-volume hospitals for cancer surgery. Cancer surgery at high-volume hospitals is associated with better short- and long-term outcomes.”

Our news journalists obtained a quote from the research from the City of Hope National Medical Center, “In the United States, health insurance is a major detriment to seeking care at high-volume hospitals. A third of older (>65 years) Americans are enrolled in privatized MA health plans. The impact of MA plan networks on access to high-volume surgery hospitals is unknown. We analyzed in-network hospitals for MA plans offered in Los Angeles county during open enrollment of 2015. For the purposes of this analysis, MA network data from provider directories were linked to hospital volume data from California Office of Statewide Health Planning and Development. Volume thresholds were based on published literature. A total of 34 MA plans enrolled 554,754 beneficiaries in Los Angeles county during 2014 open enrollment for coverage starting in 2015 (MA penetration similar to 43%). The proportion of MA plans that included high-volume cancer surgery hospital varied by the type of cancer surgery. While most plans (>71%) included at least one high-volume hospital for colon, rectum, lung, and stomach; 59% to 82% of MA plans did not include any high-volume hospitals for liver, esophagus, or pancreatic surgery. A significant proportion of beneficiaries in MA plans did not have access to high-volume hospitals for esophagus (93%), stomach (44%), liver (39%), or pancreas (70%) surgery. In contrast, nearly all MA beneficiaries had access to at least one high-volume hospital for lung (93%), colon (100%), or rectal (100%) surgery. Overall, Centers for Medicare & Medicaid Services plan rating or plan popularity were not correlated with access to high-volume hospital (P > 0.05).”

According to the news editors, the research concluded: “The study identifies lack of high-volume hospital coverage in MA health plans as a major detriment in regionalization of cancer surgery impacting at least a third of older Americans.”

This research has been peer-reviewed.

For more information on this research see: Medicare Advantage Networks and Access To High-volume Cancer Surgery Hospitals. Annals of Surgery, 2021;274(4). Annals of Surgery can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Lippincott Williams and Wilkins - www.lww.com; Annals of Surgery - http://journals.lww.com/annalsofsurgery/pages/default.aspx)

Our news journalists report that additional information may be obtained by contacting Mustafa Raoof, City of Hope National Medical Center, Dept. of Surgery, 1500 E Duarte Rd, Duarte, CA 91010, United States. Additional authors for this research include Gretchen Jacobson and Yuman Fong.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1097/sla.0000000000005098. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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