02 Dec Cancer Can Mean High Out-of-Pocket Expenses For Seniors With Only Medicare
MedicalResearch.com Interview with:
Dr. Amol K. Narang, MD
Instructor of Radiation Oncology and Molecular Radiation Sciences
Johns Hopkins Sidney Kimmel Comprehensive Cancer Center
MedicalResearch.com: What is the background for this study?
Response: We know that cancer care is becoming increasingly expensive in the U.S., but the financial impact on patients in the form of out-of-pocket expenses is not well understood, in part because of the lack of data sources that track this information. As such, we used the Health and Retirement study, a national panel study that closely tracks the out-of-pocket medical expenditures of older Americans, to understand the level of financial strain that Medicare patients experience after a new diagnosis of cancer. We further investigated what factors were associated with high financial strain and what type of health services were driving high costs in this population.
MedicalResearch.com: What are the main findings?
Response: We found that Medicare coverage still left a large portion of seniors vulnerable to high out-of-pocket costs after a diagnosis of cancer, particularly if seniors did carry additional supplemental insurance. As an example, seniors with Medicare alone and a new diagnosis of cancer experienced out-of-pocket costs that were on average 24% of their income; 10% of these patients experience out-of-pocket costs in excess of 60% of their income. Moreover, hospitalizations were a main driver of these out-of-pocket costs.
MedicalResearch.com: What should readers take away from your report?
Response: Readers should understand that Medicare patients are vulnerable to high out-of-pocket costs after a diagnosis of cancer. There are a few implications of these findings. First, we have to figure out ways to reduce wasteful spending in cancer care, since many of these costs are passed on to patients. As hospitalizations were a main driver of costs in our study, finding ways to reduce unnecessary hospitalizations can be helpful in this regard. There are a number of reports from various institutions that have shown that more intensive outpatient services to manage symptoms such as dehydration, pain, etc. can be one way to do this.
Our cancer-specific urgent care center, for example, has been successful in this regard. From a policy perspective, we should discuss the relative merits of Medicare reforms that would limit high out-of-pocket costs, such as out-of-pocket maximums, which have been proposed by various policy institutes and could better protect our seniors.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: While we globally looked at the cost of cancer care in the U.S., more granular analyses of the hospitalization patterns of each institutions’ cancer patient population would better shed light on care delivery reforms that could help reduce wasteful spending.
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