The Affordable Care Act's Medicaid Expansion and Impact Along the Cancer-Care Continuum: A Systematic Review
Health reform and the merits of Medicaid expansion remain at the top of the legislative agenda, with growing evidence suggesting an impact on cancer care and outcomes. A systematic review was undertaken to assess the association between Medicaid expansion and the goals of the Patient Protection and...
Gespeichert in:
| Veröffentlicht in: | JNCI : Journal of the National Cancer Institute Jg. 112; H. 8; S. 779 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
United States
01.08.2020
|
| Schlagworte: | |
| ISSN: | 1460-2105, 1460-2105 |
| Online-Zugang: | Weitere Angaben |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| Abstract | Health reform and the merits of Medicaid expansion remain at the top of the legislative agenda, with growing evidence suggesting an impact on cancer care and outcomes. A systematic review was undertaken to assess the association between Medicaid expansion and the goals of the Patient Protection and Affordable Care Act in the context of cancer care. The purpose of this article is to summarize the currently published literature and to determine the effects of Medicaid expansion on outcomes during points along the cancer care continuum.
A systematic search for relevant studies was performed in the PubMed/MEDLINE, EMBASE, Scopus, and Cochrane databases. Three independent observers used an abstraction form to code outcomes and perform a quality and risk of bias assessment using predefined criteria.
A total of 48 studies were identified. The most common outcomes assessed were the impact of Medicaid expansion on insurance coverage (23.4% of studies), followed by evaluation of racial and/or socioeconomic disparities (17.4%) and access to screening (14.5%). Medicaid expansion was associated with increases in coverage for cancer patients and survivors as well as reduced racial- and income-related disparities.
Medicaid expansion has led to improved access to insurance coverage among cancer patients and survivors, particularly among low-income and minority populations. This review highlights important gaps in the existing oncology literature, including a lack of studies evaluating changes in treatment and access to end-of-life care following implementation of expansion. |
|---|---|
| AbstractList | Health reform and the merits of Medicaid expansion remain at the top of the legislative agenda, with growing evidence suggesting an impact on cancer care and outcomes. A systematic review was undertaken to assess the association between Medicaid expansion and the goals of the Patient Protection and Affordable Care Act in the context of cancer care. The purpose of this article is to summarize the currently published literature and to determine the effects of Medicaid expansion on outcomes during points along the cancer care continuum.BACKGROUNDHealth reform and the merits of Medicaid expansion remain at the top of the legislative agenda, with growing evidence suggesting an impact on cancer care and outcomes. A systematic review was undertaken to assess the association between Medicaid expansion and the goals of the Patient Protection and Affordable Care Act in the context of cancer care. The purpose of this article is to summarize the currently published literature and to determine the effects of Medicaid expansion on outcomes during points along the cancer care continuum.A systematic search for relevant studies was performed in the PubMed/MEDLINE, EMBASE, Scopus, and Cochrane databases. Three independent observers used an abstraction form to code outcomes and perform a quality and risk of bias assessment using predefined criteria.METHODSA systematic search for relevant studies was performed in the PubMed/MEDLINE, EMBASE, Scopus, and Cochrane databases. Three independent observers used an abstraction form to code outcomes and perform a quality and risk of bias assessment using predefined criteria.A total of 48 studies were identified. The most common outcomes assessed were the impact of Medicaid expansion on insurance coverage (23.4% of studies), followed by evaluation of racial and/or socioeconomic disparities (17.4%) and access to screening (14.5%). Medicaid expansion was associated with increases in coverage for cancer patients and survivors as well as reduced racial- and income-related disparities.RESULTSA total of 48 studies were identified. The most common outcomes assessed were the impact of Medicaid expansion on insurance coverage (23.4% of studies), followed by evaluation of racial and/or socioeconomic disparities (17.4%) and access to screening (14.5%). Medicaid expansion was associated with increases in coverage for cancer patients and survivors as well as reduced racial- and income-related disparities.Medicaid expansion has led to improved access to insurance coverage among cancer patients and survivors, particularly among low-income and minority populations. This review highlights important gaps in the existing oncology literature, including a lack of studies evaluating changes in treatment and access to end-of-life care following implementation of expansion.CONCLUSIONSMedicaid expansion has led to improved access to insurance coverage among cancer patients and survivors, particularly among low-income and minority populations. This review highlights important gaps in the existing oncology literature, including a lack of studies evaluating changes in treatment and access to end-of-life care following implementation of expansion. Health reform and the merits of Medicaid expansion remain at the top of the legislative agenda, with growing evidence suggesting an impact on cancer care and outcomes. A systematic review was undertaken to assess the association between Medicaid expansion and the goals of the Patient Protection and Affordable Care Act in the context of cancer care. The purpose of this article is to summarize the currently published literature and to determine the effects of Medicaid expansion on outcomes during points along the cancer care continuum. A systematic search for relevant studies was performed in the PubMed/MEDLINE, EMBASE, Scopus, and Cochrane databases. Three independent observers used an abstraction form to code outcomes and perform a quality and risk of bias assessment using predefined criteria. A total of 48 studies were identified. The most common outcomes assessed were the impact of Medicaid expansion on insurance coverage (23.4% of studies), followed by evaluation of racial and/or socioeconomic disparities (17.4%) and access to screening (14.5%). Medicaid expansion was associated with increases in coverage for cancer patients and survivors as well as reduced racial- and income-related disparities. Medicaid expansion has led to improved access to insurance coverage among cancer patients and survivors, particularly among low-income and minority populations. This review highlights important gaps in the existing oncology literature, including a lack of studies evaluating changes in treatment and access to end-of-life care following implementation of expansion. |
| Author | Moss, Haley A Kaplan, Samantha J Wu, Jenny Zafar, S Yousuf |
| Author_xml | – sequence: 1 givenname: Haley A surname: Moss fullname: Moss, Haley A organization: Duke Cancer Institute, Durham, NC, USA – sequence: 2 givenname: Jenny surname: Wu fullname: Wu, Jenny organization: Duke University School of Medicine, Durham NC, USA – sequence: 3 givenname: Samantha J surname: Kaplan fullname: Kaplan, Samantha J organization: Duke University School of Medicine, Durham NC, USA – sequence: 4 givenname: S Yousuf surname: Zafar fullname: Zafar, S Yousuf organization: Duke Cancer Institute, Duke-Margolis Center for Health Policy, Durham, NC, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32277814$$D View this record in MEDLINE/PubMed |
| BookMark | eNpNkEtPwzAQhC1URB9w44x8g0uoYzuJw62KClQqQoJyjhx7TV0lTogToP-eAEViLzMjfbNa7RSNXO0AofOQXIckZfOdU3aud1ISzo7QJOQxCWhIotE_P0ZT73dkmJTyEzRmlCaJCPkElZst4IUxdatlUQLOZDtk1V16_ADaKmk1Xn420nlbOyydxquqkarDi7J2r7jbflecgjb4aWa166zr--oGL_Dz3ndQyc4q_ATvFj5O0bGRpYezg87Qy-1yk90H68e7VbZYB4pz3gUaTFKYJE0JFGK4frCcQQgSFGFhJArCCDeURoYwlsaFBkFEFBtWaKJjEHSGrn73Nm391oPv8sp6BWUpHdS9zykTQjASJmRALw5oX1Sg86a1lWz3-d-H6BfjmGlf |
| CitedBy_id | crossref_primary_10_1002_cam4_4842 crossref_primary_10_1093_jnci_djac064 crossref_primary_10_1002_lio2_698 crossref_primary_10_1002_cncr_33506 crossref_primary_10_1016_j_jcpo_2021_100317 crossref_primary_10_1002_pbc_29370 crossref_primary_10_1007_s11764_024_01710_3 crossref_primary_10_1016_j_oraloncology_2022_106055 crossref_primary_10_1245_s10434_025_17082_6 crossref_primary_10_1001_jamanetworkopen_2021_24280 crossref_primary_10_1002_cncr_34956 crossref_primary_10_1016_j_soc_2025_04_010 crossref_primary_10_1007_s10552_023_01730_x crossref_primary_10_1007_s11764_025_01830_4 crossref_primary_10_1016_j_jacr_2022_09_036 crossref_primary_10_3322_caac_70006 crossref_primary_10_1016_j_jaad_2021_04_087 crossref_primary_10_1097_HC9_0000000000000190 crossref_primary_10_1007_s10620_022_07659_6 crossref_primary_10_1093_jnci_djae111 crossref_primary_10_1016_j_ajog_2021_09_034 crossref_primary_10_1093_jncics_pkae011 crossref_primary_10_1001_jamanetworkopen_2022_22220 crossref_primary_10_1002_ohn_1336 crossref_primary_10_3390_cancers17010061 crossref_primary_10_1002_cncr_34347 crossref_primary_10_1002_cncr_33330 crossref_primary_10_1002_cncr_34067 crossref_primary_10_1016_j_canep_2025_102747 crossref_primary_10_1016_j_oor_2024_100653 crossref_primary_10_1001_jamainternmed_2024_1655 crossref_primary_10_1111_jep_14055 crossref_primary_10_1002_hed_28185 crossref_primary_10_1002_jso_27070 crossref_primary_10_1146_annurev_publhealth_071723_113826 crossref_primary_10_1016_j_jcpo_2021_100292 crossref_primary_10_1093_jncimonographs_lgac011 crossref_primary_10_1177_10775587211042532 crossref_primary_10_1016_j_jtocrr_2024_100643 crossref_primary_10_1002_cam4_6168 crossref_primary_10_1002_cam4_5593 crossref_primary_10_1002_cncr_35904 crossref_primary_10_1016_j_amepre_2021_09_005 crossref_primary_10_1002_hed_70006 crossref_primary_10_1002_jso_26984 crossref_primary_10_1016_j_canep_2021_102059 crossref_primary_10_1001_jamanetworkopen_2021_7051 crossref_primary_10_1093_jnci_djab105 crossref_primary_10_1177_10442073221118124 crossref_primary_10_1007_s40615_021_01018_3 crossref_primary_10_1016_j_ygyno_2020_08_006 crossref_primary_10_1093_jnci_djad087 crossref_primary_10_1093_jnci_djac077 crossref_primary_10_1016_j_gassur_2024_01_042 crossref_primary_10_1093_jncimonographs_lgac008 crossref_primary_10_1016_j_transproceed_2022_12_008 crossref_primary_10_1001_jamanetworkopen_2023_51529 crossref_primary_10_1002_cnr2_1840 crossref_primary_10_1002_ohn_1198 crossref_primary_10_1177_00031348211060452 crossref_primary_10_1111_1475_6773_14315 crossref_primary_10_1002_cam4_7461 crossref_primary_10_1097_XCS_0000000000000018 crossref_primary_10_1001_jamanetworkopen_2025_0522 crossref_primary_10_3390_healthcare10061066 |
| ContentType | Journal Article |
| Copyright | The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com. |
| Copyright_xml | – notice: The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com. |
| DBID | CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.1093/jnci/djaa043 |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE - Academic MEDLINE |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1460-2105 |
| ExternalDocumentID | 32277814 |
| Genre | Systematic Review Journal Article Research Support, N.I.H., Extramural |
| GeographicLocations | United States |
| GeographicLocations_xml | – name: United States |
| GrantInformation_xml | – fundername: NICHD NIH HHS grantid: K12 HD043446 |
| GroupedDBID | --- -E4 -~X .2P .I3 .XZ .ZR 08P 0R~ 1TH 29L 2WC 354 4.4 482 48X 5GY 5RE 5VS 5WD 70D 96U AABZA AACZT AAHTB AAJKP AAMVS AAOGV AAPNW AAPQZ AAPXW AARHZ AAUAY AAUQX AAVAP AAWTL ABCQX ABDFA ABEJV ABEUO ABGNP ABIXL ABJNI ABKDP ABNHQ ABNKS ABOCM ABPEJ ABPPZ ABPTD ABQLI ABQNK ABVGC ABXVV ABZBJ ACBMB ACGFO ACGFS ACGOD ACKOT ACNCT ACPRK ACUFI ACUTJ ACUTO ACYHN ADBBV ADEYI ADEZT ADGZP ADHKW ADHZD ADIPN ADNBA ADOCK ADQBN ADRTK ADVEK ADYVW AEGPL AEJOX AEKSI AEMDU AEMQT AENZO AEPUE AETBJ AEWNT AFAZI AFFNX AFFZL AFIYH AFOFC AFRAH AFXAL AFYAG AGINJ AGKEF AGORE AGSYK AGUTN AHGBF AHMBA AHMMS AHXPO AIAGR AIJHB AJBYB AJEEA AJNCP ALMA_UNASSIGNED_HOLDINGS ALUQC ALXQX APIBT APWMN ATGXG BAWUL BAYMD BCRHZ BEYMZ BTRTY BVRKM C45 CDBKE CGR CS3 CUY CVF CZ4 DAKXR DIK DILTD DU5 D~K E3Z EBS ECM EE~ EIF EMOBN ENERS F5P F8P F9B FECEO FLUFQ FOEOM FOTVD FQBLK GAUVT GJXCC GX1 H13 H5~ HAR HW0 HZ~ IH2 IOX J21 JXSIZ KAQDR KBUDW KOP KQ8 KSI KSN L7B M-Z MHKGH ML0 N9A NGC NOMLY NOYVH NPM NU- OAUYM OAWHX OBH OCB OCZFY ODMLO ODZKP OGEVE OHH OJQWA OJZSN OK1 OPAEJ OVD OWPYF P2P PAFKI PEELM PQQKQ Q.- Q1. Q5Y R44 RD5 RNS ROL ROX ROZ RUSNO RW1 RXO TCURE TEORI TJX TMA TR2 TWZ UDS UPT VVN W8F WH7 WOQ X7H YAYTL YKOAZ YQT YXANX ZKX ZRR ZY1 ~91 ~H1 7X8 |
| ID | FETCH-LOGICAL-c444t-def7bf7990eb8105f7943e1eaec03158b0304f225f03396bde80856f3bd0d6e82 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 73 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000593052700003&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1460-2105 |
| IngestDate | Mon Sep 29 06:24:17 EDT 2025 Mon Jul 21 05:59:26 EDT 2025 |
| IsDoiOpenAccess | false |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 8 |
| Language | English |
| License | The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c444t-def7bf7990eb8105f7943e1eaec03158b0304f225f03396bde80856f3bd0d6e82 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 |
| OpenAccessLink | https://www.ncbi.nlm.nih.gov/pmc/articles/7825479 |
| PMID | 32277814 |
| PQID | 2388830170 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_2388830170 pubmed_primary_32277814 |
| PublicationCentury | 2000 |
| PublicationDate | 2020-08-01 |
| PublicationDateYYYYMMDD | 2020-08-01 |
| PublicationDate_xml | – month: 08 year: 2020 text: 2020-08-01 day: 01 |
| PublicationDecade | 2020 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | JNCI : Journal of the National Cancer Institute |
| PublicationTitleAlternate | J Natl Cancer Inst |
| PublicationYear | 2020 |
| SSID | ssj0000924 |
| Score | 2.5771956 |
| SecondaryResourceType | review_article |
| Snippet | Health reform and the merits of Medicaid expansion remain at the top of the legislative agenda, with growing evidence suggesting an impact on cancer care and... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 779 |
| SubjectTerms | Continuity of Patient Care - economics Continuity of Patient Care - organization & administration Continuity of Patient Care - standards Health Care Reform - economics Health Care Reform - methods Health Care Reform - organization & administration Health Services Accessibility - economics Health Services Accessibility - legislation & jurisprudence Health Services Accessibility - organization & administration Healthcare Disparities - economics Healthcare Disparities - legislation & jurisprudence Healthcare Disparities - organization & administration Healthcare Disparities - statistics & numerical data Humans Insurance Coverage - economics Insurance Coverage - legislation & jurisprudence Insurance Coverage - organization & administration Medicaid - economics Medicaid - legislation & jurisprudence Medicaid - organization & administration Minority Groups - statistics & numerical data Neoplasms - economics Neoplasms - epidemiology Neoplasms - therapy Patient Protection and Affordable Care Act - economics Poverty - economics Poverty - statistics & numerical data Preventive Medicine - economics Preventive Medicine - methods Preventive Medicine - organization & administration Preventive Medicine - statistics & numerical data Quality Improvement - economics Quality Improvement - organization & administration Quality Improvement - standards Survival Analysis Terminal Care - economics Terminal Care - organization & administration Terminal Care - standards United States - epidemiology |
| Title | The Affordable Care Act's Medicaid Expansion and Impact Along the Cancer-Care Continuum: A Systematic Review |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/32277814 https://www.proquest.com/docview/2388830170 |
| Volume | 112 |
| WOSCitedRecordID | wos000593052700003&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1JS8NAFB7UinhxX-rGCIKnoVmmmakXCdKih5aCCr2VySySUtPatOLP970ktSdB8JJTBsLLm7e_7yPkRgdaKuMnTODaMtehZS0VcmaEdbppFBeeKcgmRK8nB4NWvyq45dVY5dImFobaTDTWyBvgWqQMEe3lfvrBkDUKu6sVhcY6qYUQyqBWi8EKLdxrlaS2PPIYpDbNavAdkvjGKNNpw4yU8nBf57fgsnAynd3_ft4e2anCSxqX-rBP1mx2QLa6VQP9kIxBLWjscKIdd6Yorh_RWM9vc1q2bFJD219gIbCIRlVm6FOxRknj8SR7oxAtwhHQkxkrTiK2VZotFu93NKbPP6DQtOw4HJHXTvvl4ZFVhAtMc87nzFgnEifAQdlEgrwcosdZ3yqrkQxCJthHdWABnBeGrSgxVkLEFrkwMZ6JrAyOyUY2yewpofBuVEDnC2m5z5UKlBco0xS6mUjne3VyvZTjEBQauxQqs5NFPlxJsk5Oyp8xnJbIG0OwPgIxus7-cPqcbAeYGxfDehek5uA620uyqT_naT67KjQFnr1-9xt93siL |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=The+Affordable+Care+Act%27s+Medicaid+Expansion+and+Impact+Along+the+Cancer-Care+Continuum%3A+A+Systematic+Review&rft.jtitle=JNCI+%3A+Journal+of+the+National+Cancer+Institute&rft.au=Moss%2C+Haley+A&rft.au=Wu%2C+Jenny&rft.au=Kaplan%2C+Samantha+J&rft.au=Zafar%2C+S+Yousuf&rft.date=2020-08-01&rft.eissn=1460-2105&rft.volume=112&rft.issue=8&rft.spage=779&rft_id=info:doi/10.1093%2Fjnci%2Fdjaa043&rft_id=info%3Apmid%2F32277814&rft_id=info%3Apmid%2F32277814&rft.externalDocID=32277814 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1460-2105&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1460-2105&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1460-2105&client=summon |