Impact of chronic conditions on the cost of cancer care for medicaid beneficiaries

• Type of Material: Article
• Authors: Sujha Subramanian, RTI International; Florence K.L. Tangka, Centers for Disease Control and Prevention; Susan A. Sabatino, Centers for Disease Control and Prevention; David Howard, Emory University; Lisa C. Richardson, Centers for Disease Control and Prevention; Susan Haber, RTI International; Michael T. Halpern, RTI International; Sonja Hoover, RTI International
• Language: English
• Date: 2012-12-01
• Publisher: Centers for Medicare & Medicaid Services
• Publication Version: Final Published Version
• Copyright Statement: All material in the Medicare & Medicaid Research Review is in the public domain and may be duplicated without permission.
• Final Published Version (URL): http://dx.doi.org/10.5600/mmrr.002.04.a07
• Title of Journal or Parent Work: Medicare & medicaid research review
• ISSN: 2159-0354
• Volume: 2
• Issue: 4
• Start Page: E1
• End Page: E21
• Grant/Funding Information: Funding support was provided by the Centers for Disease Control and Prevention (Contract No. 200-2002-00575, Task order 025).
• Keywords: Health Care Costs; Male; Female; Chronic Disease; Medicaid; Neoplasms; Young Adult; Middle Aged; Adult; Aged; Humans; Registries; chronic disease; United States; healtchcare costs
• Research Categories: Health Sciences, Oncology; Health Sciences, Health Care Management; Health Sciences, Public Health

Abstract

Background No study has assessed the cost of treating adult Medicaid cancer patients with preexisting chronic conditions. This information is essential for understanding the cost of cancer care to the Medicaid program above that expended for other chronic conditions, given the increasing prevalence of chronic conditions among cancer patients. Research Design We used administrative data from 3 state Medicaid programs' linked cancer registry data to estimate cost of care during the first 6 months following cancer diagnosis for beneficiaries with 4 preexisting chronic conditions: cardiac disease, respiratory diseases, diabetes, and mental health disorders. Our base cohort consisted of 6,212 Medicaid cancer patients aged 21 to 64 years (cancer diagnosed during 2001-2003) who were continuously enrolled in fee-for-service Medicaid for 6 months after diagnosis. A subset of these patients who did not die during the 6-month follow-up (n=4,628), were matched with 2 non-cancer patients each (n=8,536) to assess incremental cost of care. Results The average cost of care for cancer patients with the chronic conditions studied was higher than for cancer patients without any of these conditions. The increase in cancer treatment cost associated with the chronic conditions ranged from $4,385 for cardiac disease to $11,009 for mental health disorders. Conclusions Chronic conditions, especially the presence of multiple conditions, are associated with a higher cost of care among Medicaid cancer patients, and these increased costs should be reflected in projections of future Medicaid cancer care costs. The implementation of better care-management processes for cancer patients with preexisting chronic conditions may be one way to reduce these costs.