{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T15:47:04Z","timestamp":1773676024660,"version":"3.50.1"},"reference-count":29,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"5","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncol Pract"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n            <jats:title>PURPOSE<\/jats:title>\n            <jats:p>Increasingly, states outsource administration of Medicaid insurance to privately administered Medicaid managed care organizations. However, on January 1, 2012, Connecticut transitioned from a privately to publicly administered Medicaid system. New Jersey retained a private model.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>Our objective was to assess rates of early-stage cancer diagnosis and cancer survival in two states with similar sociodemographic characteristics but differing exposures to Medicaid privatization. Using data from the SEER Program between 2007 and 2016, Connecticut and New Jersey Medicaid patients with 10 common solid cancers including breast, lung, colorectal, prostate, kidney, bladder, cervix, uterus, head and neck cancer, and melanoma were included. A difference-in-differences analysis of stage of cancer presentation and cancer survival in Connecticut (intervention) was compared with New Jersey (control).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>Among 29,328 patients (14,424 patients from Connecticut and 14,904 patients from New Jersey) parallel trends were verified in early cancer diagnosis and survival for both states under privately administered Medicaid (pre-exposure). Connecticut's transition from privately to publicly administered Medicaid was associated with an adjusted 4.0% increase in overall early-stage cancer diagnosis (95% CI, +1.7% to +6.2%) and a 4.7% increase in early-stage cancer diagnosis for cancers with US Preventive Services Taskforce A\/B recommendations for cancer screening (95% CI, 1.6% to 7.8%). Public administration of Medicaid was also associated with improved overall survival after cancer diagnosis (hazard ratio, 0.92 [95% CI, 0.85 to 0.99]). No changes were observed in New Jersey.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>Transition from private to public administration of Medicaid in Connecticut was associated with earlier-stage cancer diagnosis and improved cancer survival.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1200\/op.23.00297","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T21:00:19Z","timestamp":1706734819000},"page":"708-716","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":4,"title":["Association of Medicaid Privatization With Patient Cancer Outcomes"],"prefix":"10.1200","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4275-8939","authenticated-orcid":true,"given":"Pranit R.","family":"Sunkara","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6371-6729","authenticated-orcid":true,"given":"Jacob","family":"Waitzman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2126-6663","authenticated-orcid":true,"given":"Nicholas R.","family":"Lenze","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4926-0957","authenticated-orcid":true,"given":"Michael J.","family":"Brenner","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6869-8554","authenticated-orcid":true,"given":"John D.","family":"Cramer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1215\/03616878-4303489"},{"key":"e_1_3_5_3_2","first-page":"1","article-title":"Overview of the Medicare and Medicaid programs","volume":"22","author":"Hoffman EDJ","year":"2005","unstructured":"Hoffman EDJ, Klees BS, Curtis CA: Overview of the Medicare and Medicaid programs. Health Care Financ Rev Stat Suppl 22:1-304, 2005","journal-title":"Health Care Financ Rev Stat Suppl"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1215\/03616878-8255541"},{"key":"e_1_3_5_5_2","volume-title":"Enrollment Report: Medicaid","author":"Centers for Medicare & Medicaid Services","unstructured":"Centers for Medicare & Medicaid Services: Enrollment Report: Medicaid. https:\/\/www.medicaid.gov\/medicaid\/managed-care\/enrollment-report\/index.html"},{"key":"e_1_3_5_6_2","volume-title":"Managed Care: Medicaid","author":"Centers for Medicare & Medicaid Services","unstructured":"Centers for Medicare & Medicaid Services: Managed Care: Medicaid. https:\/\/www.medicaid.gov\/medicaid\/managed-care\/index.html"},{"key":"e_1_3_5_7_2","volume-title":"Efficiency Gains from Medicaid Privatization: Identifying the Magnitude and Incidence","author":"Duggan M","year":"2013","unstructured":"Duggan M: Efficiency Gains from Medicaid Privatization: Identifying the Magnitude and Incidence. Population Studies Center, 2013. https:\/\/www.pop.upenn.edu\/pilot-award\/efficiency-gains-medicaid-privatization-identifying-magnitude-and-incidence"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2013.04.119"},{"key":"e_1_3_5_9_2","volume-title":"How Do Dual-Eligible Individuals Get Their Medicare Coverage?","author":"Maria TP","year":"2023","unstructured":"Maria TP: How Do Dual-Eligible Individuals Get Their Medicare Coverage? KFF, 2023. https:\/\/www.kff.org\/medicare\/issue-brief\/how-do-dual-eligible-individuals-get-their-medicare-coverage\/"},{"key":"e_1_3_5_10_2","article-title":"Connecticut drops insurers from Medicaid","author":"Galewitz P","year":"2011","unstructured":"Galewitz P: Connecticut drops insurers from Medicaid. Kaiser Health News. 2011. https:\/\/khn.org\/news\/connecticut-drops-insurers-from-medicaid\/","journal-title":"Kaiser Health News"},{"key":"e_1_3_5_11_2","unstructured":"Vestal C: Connecticut revisits old-school Medicaid financing. 2012. http:\/\/pew.org\/1LCuAEs"},{"key":"e_1_3_5_12_2","volume-title":"How Connecticut Eliminated Capitated Managed Care in Medicaid: JustCare","author":"Archer D","unstructured":"Archer D, Toubman S: How Connecticut Eliminated Capitated Managed Care in Medicaid: JustCare. https:\/\/justcareusa.org\/how-connecticut-eliminated-capitated-managed-care-in-medicaid\/"},{"key":"e_1_3_5_13_2","volume-title":"Surveillance, Epidemiology, and End Results Program","author":"National Cancer Institute","unstructured":"National Cancer Institute: Surveillance, Epidemiology, and End Results Program. SEER. https:\/\/seer.cancer.gov\/index.html"},{"key":"e_1_3_5_14_2","volume-title":"2007 Multiple Primary and Histology Coding Rules","author":"Surveillance, Epidemiology, and End Results","unstructured":"Surveillance, Epidemiology, and End Results: 2007 Multiple Primary and Histology Coding Rules. https:\/\/seer.cancer.gov\/tools\/mphrules\/"},{"key":"e_1_3_5_15_2","volume-title":"Social Security Administration Research, Statistics, and Policy Analysis","author":"Whitman K","year":"2011","unstructured":"Whitman K; Social Security Administration: Social Security Administration Research, Statistics, and Policy Analysis. 2011. https:\/\/www.ssa.gov\/policy\/docs\/ssb\/v71n2\/v71n2p17.html#:\u223c:text=Nearly%204%20percent%20of%20the,as%20shown%20in%20Table%201"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/PHH.0b013e31821a3f8c"},{"key":"e_1_3_5_17_2","volume-title":"10 Things to Know about Medicaid Managed Care","author":"Hinton E","year":"2023","unstructured":"Hinton E: 10 Things to Know about Medicaid Managed Care. KFF, 2023. https:\/\/www.kff.org\/medicaid\/issue-brief\/10-things-to-know-about-medicaid-managed-care\/"},{"key":"e_1_3_5_18_2","volume-title":"A and B Recommendations","author":"United States Preventive Services Taskforce","year":"2022","unstructured":"United States Preventive Services Taskforce: A and B Recommendations. 2022. https:\/\/www.uspreventiveservicestaskforce.org\/uspstf\/recommendation-topics\/uspstf-a-and-b-recommendations"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6908a1"},{"key":"e_1_3_5_20_2","first-page":"559","article-title":"A comparison of relative resource use and quality in Medicare Advantage health plans versus traditional Medicare","volume":"21","author":"Landon BE","year":"2015","unstructured":"Landon BE, Zaslavsky AM, Saunders R, et al: A comparison of relative resource use and quality in Medicare Advantage health plans versus traditional Medicare. Am J Manag Care 21:559-566, 2015","journal-title":"Am J Manag Care"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200011163432006"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.20982"},{"key":"e_1_3_5_23_2","first-page":"27","article-title":"Medicaid managed-care patients face hurdles in getting care","volume":"45","author":"Taitsman J","year":"2015","unstructured":"Taitsman J: Medicaid managed-care patients face hurdles in getting care. Mod Healthc 45:27, 2015","journal-title":"Mod Healthc"},{"key":"e_1_3_5_24_2","volume-title":"Medicaid Managed Care in Connecticut and Other States","author":"Fitzpatrick M","unstructured":"Fitzpatrick M, Dwyer KM: Medicaid Managed Care in Connecticut and Other States. https:\/\/www.cga.ct.gov\/2015\/rpt\/2015-R-0010.htm"},{"key":"e_1_3_5_25_2","volume-title":"Managed Care in New Jersey","year":"2014","unstructured":"Managed Care in New Jersey. The Official US Governement Site for Medicare and Medicaid, 2014. https:\/\/www.medicaid.gov\/sites\/default\/files\/2020-02\/new-jersey-mcp.pdf"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e31819c95aa"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.59.1933"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.37765\/ajmc.2021.88581"},{"key":"e_1_3_5_29_2","volume-title":"Lower Medicaid Provider Fees","author":"Herrick DD","unstructured":"Herrick DD, Gorman DL: Lower Medicaid Provider Fees. Mackinac Center. https:\/\/www.mackinac.org\/18786"},{"key":"e_1_3_5_30_2","volume-title":"Physician Acceptance of New Medicaid Patients: Findings from the National Electronic Health Records Survey","author":"Medicaid and CHIP Payment, and Access Commission","year":"2023","unstructured":"Medicaid and CHIP Payment, and Access Commission: Physician Acceptance of New Medicaid Patients: Findings from the National Electronic Health Records Survey. 2023"}],"container-title":["JCO Oncology Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/OP.23.00297","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T17:12:17Z","timestamp":1727629937000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/OP.23.00297"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":29,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1200\/OP.23.00297"],"URL":"https:\/\/doi.org\/10.1200\/op.23.00297","relation":{},"ISSN":["2688-1527","2688-1535"],"issn-type":[{"value":"2688-1527","type":"print"},{"value":"2688-1535","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5]]},"assertion":[{"value":"2023-05-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-25","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}