Bottom Line: Researchers for this observational study examined the association between the expansion of Medicaid coverage in some states after the Patient Protection and Affordable Care Act (ACA) was passed and the diagnosis and treatment of patients with head and neck squamous cell carcinoma (HNSCC). The analysis included nearly 91,000 adults with newly diagnosed HNSCC who were identified from the National Cancer Database. Researchers report that between the pre-ACA (2010-2013) and post-ACA (2014-1026) periods, the percentage of uninsured patients with HNSCC decreased but those decreases didn't differ significantly between expansion and nonexpansion states. The percentage of patients diagnosed with localized (stage I or II) HNSCC decreased from the pre-ACA to post-ACA periods in both expansion and nonexpansion states but the decreases were smaller in Medicaid expansion states so that resulted in a small relative increase in patients diagnosed with localized disease in Medicaid expansion states. The average time to beginning treatment didn't differ overall between expansion and nonexpansion states but was improved for patients with nonoropharyngeal HNSCC ?in expansion states relative to nonexpansion states. Limitations of the study include possible misclassification of insurance coverage.
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Authors: Evan M. Graboyes, M.D., Medical University of South Carolina, Charleston, and coauthors.
(doi:10.1001/jamaoto.2019.4310)
Editor's Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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Media advisory: To contact corresponding author Evan M. Graboyes, M.D., email Montez Seabrook at seabromo@musc.edu">seabromo@musc.edu. The full study is linked to this news release.Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/10.1001/jamaoto.2019.4310?guestAccessKey=7d558789-063d-4e77-a908-e043b73f939b&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=011620
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