MedicalResearch.com Interview with:
Andrew P. Loehrer, MD
David Torchiana Fellow in Health Policy and Management
Massachusetts General Physicians Organization
Codman Center for Clinical Effectiveness in Surgery
Department of Surgery
Massachusetts General Hospital
Medical Research: What is the background for this study? What are the main findings?
Dr. Loehrer: The incidence of pancreatic cancer is increasing and is on pace to become the second leading cause of cancer mortality by the year 2020. While surgery remains the only chance for long-term survival, significant and persistent disparities in evaluation for and receipt of surgery remain for underinsured patients across the United States. The Affordable Care Act aims to increase access to care through expansion of health insurance coverage and was modeled on previous reform in the Commonwealth of Massachusetts.
We evaluated the impact of the 2006 Massachusetts health reform on rates of surgery for pancreatic cancer. We found the insurance expansion to be independently associated with a 67% increased rate of resection for pancreatic cancer. While disparities in resection rates by insurance status decreased after the health reform, significant gaps remain between privately-insured patients and government-subsidized/self-pay patients.
Medical Research: What should clinicians and patients take away from your report?
Dr. Loehrer: Our findings strongly suggest that increasing access to care through insurance coverage across a population may indeed help increase receipt of appropriate, life-saving care. Providers, patients, and communities at large should strongly weigh the clinical implications of insurance expansion as other states across the country consider whether or not to expand coverage as a part of the Affordable Care Act.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Loehrer: While our data are consistent with other studies from Massachusetts reinforcing the importance of insurance expansion for improved patient care, ongoing studies are needed to evaluate the impact of insurance expansion (or lack thereof) in other states across the country. Furthermore, additional studies are needed to evaluate the accessibility of appropriate, multidisciplinary care for pancreatic cancer in vulnerable populations across the country.
Published Online: October 08, 2015
Andrew P. Loehrer, MD (2015). Insurance Expansion Increased Access To Pancreatic Cancer Surgery