Cathy J. Bradley

Prescription Drug Coverage: Implications for hormonal therapy adherence in women diagnosed with breast cancer

In spite of its demonstrated benefits, many women do not initiate hormonal therapy, and among those who do, many discontinue it prematurely. We examined whether differences in hormonal therapy adherence may be at least partially explained by the availability of prescription drug coverage. Women aged 20–79xa0years diagnosed with stage I-III breast cancer between June 2005 and February 2007 were enrolled in the study. Women completed a mailed survey, on average 9xa0months after diagnosis, and again approximately 4xa0years later (Nxa0=xa0712). Adjusted logistic regression was used to predict the likelihood of initiating hormonal therapy and hormonal therapy continuation. Women who had prescription drug coverage were more likely to initiate hormonal therapy relative to women without prescription drug coverage (OR 2.91, 95xa0% CI 1.24–6.84). Women with prescription drug coverage were also more likely to continue hormonal therapy (OR 2.23; 95xa0% CI 0.99–5.05, pxa0=xa00.0543). The lowest income women were also less likely to continue hormonal therapy relative to women with annual household income that exceeded

Medicaid expansion and access to care among cancer survivors: a baseline overview.

70,000 (OR 0.55; 95xa0% CI 0.29–1.04) with a borderline significance of (pxa0=xa00.08). This study demonstrates the critical role of prescription drug coverage in hormonal therapy initiation and continuation, independent of health insurance coverage. These findings add to the body of literature that addresses medication adherence. Financial factors must be considered along with behavioral factors that influence adherence, which is becoming increasingly relevant to oncology as treatments are shifted to oral medications, many of which are very expensive.

Impact of Medicaid disenrollment in Tennessee on breast cancer stage at diagnosis and treatment

PurposeMedicaid expansion under the Affordable Care Act facilitates access to care among vulnerable populations, but 21 states have not yet expanded the program. Medicaid expansions may provide increased access to care for cancer survivors, a growing population with chronic conditions. We compare access to health care services among cancer survivors living in non-expansion states to those living in expansion states, prior to Medicaid expansion under the Affordable Care Act.MethodsWe use the 2012 and 2013 Behavioral Risk Factor Surveillance System to estimate multiple logistic regression models to compare inability to see a doctor because of cost, having a personal doctor, and receiving an annual checkup in the past year between cancer survivors who lived in non-expansion states and survivors who lived in expansion states.ResultsCancer survivors in non-expansion states had statistically significantly lower odds of having a personal doctor (adjusted odds ratio [AOR] 0.76, 95xa0% confidence interval [CI] 0.63–0.92, pu2009<u20090.05) and higher odds of being unable to see a doctor because of cost (AOR 1.14, 95xa0% CI 0.98–1.31, pu2009<u20090.10). Statistically significant differences were not found for annual checkups.ConclusionsPrior to the passage of the Affordable Care Act, cancer survivors living in expansion states had better access to care than survivors living in non-expansion states. Failure to expand Medicaid could potentially leave many cancer survivors with limited access to routine care.Implications for Cancer SurvivorsExisting disparities in access to care are likely to widen between cancer survivors in Medicaid non-expansion and expansion states.

Medicaid Expansions and Cervical Cancer Screening for Low‐Income Women

States routinely may consider rollbacks of Medicaid expansions to address statewide economic conditions. To the authors knowledge, little is known regarding the effects of public insurance contractions on health outcomes. The current study examined the effects of the 2005 Medicaid disenrollment in Tennessee on breast cancer stage at the time of diagnosis and delays in treatment among nonelderly women.

Small Cash Incentives Can Encourage Primary Care Visits By Low-Income People With New Health Care Coverage

OBJECTIVEnMedicaid coverage for low-income women may play an important role in ensuring access to preventive care. This study examines how Medicaid eligibility expansions to nonelderly adults impact cervical cancer screening among low-income women.nnnDATA SOURCESnWe use data from the Behavioral Risk Factor Surveillance System from 2000 to 2010. The primary outcome of interest is whether women in the relevant guideline consistent age range reported having a Pap test in the previous year.nnnSTUDY DESIGNnWe use a difference-in-differences approach with matched treatment and comparison states and a simulated eligibility approach based on a continuous measure of Medicaid generosity.nnnPRINCIPAL FINDINGSnOur results indicate that cervical cancer screening increased among low-income women in expansion states relative to comparison states. Increases in screening rates are largest among low-income Hispanic women.nnnCONCLUSIONSnMedicaid expansions during the period from 2000 to 2010 were associated with improved cervical cancer screening rates, which is critical for early cervical cancer detection and prevention of cancer morbidity and mortality in women. The results suggest that more widespread Medicaid expansions may have positive effects on preventive health care for women.

Cancer Survivorship and Employment: Intersection of Oral Agents, Changing Workforce Dynamics, and Employers’ Perspectives

In a randomized controlled trial, we studied low-income adults newly covered by a primary care program to determine whether a cash incentive could encourage them to make an initial visit to a primary care provider. Subjects were randomly assigned to one of four groups: three groups whose members received

Recommendations for Research and Practice to Improve Work Outcomes Among Cancer Survivors

10 to complete a baseline survey during an interview and who were randomized to incentives of

The effect of primary care visits on other health care utilization: A randomized controlled trial of cash incentives offered to low income, uninsured adults in Virginia

50,

Understanding the Limitations of Cancer Registry Insurance Data—Implications for Policy

25, or

Medicaid expansions and labor supply among low-income childless adults: evidence from 2000 to 2013

0 to visit their assigned primary care provider within six months after enrolling in the study; and a nonincentivized control group not contacted by the research team. Subjects in the