Disenrollment From Medicaid After Recent Cancer Diagnosis

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Abstract
Objectives: We examine the frequency with which newly diagnosed cancer patients are covered by Medicaid in Washington State and the duration of coverage. Methods: Medicaid enrollment and claims files were linked to the Washington State Cancer Registry to identify all Medicaid enrollees with breast, cervical, lung, colorectal, and prostate cancer between 1997 and 2002. Results: We identified 5009 newly diagnosed cancer patients covered by Medicaid, approximately 13% of the total cases diagnosed in subjects less than 65 years of age in Washington State. The majority, 2866 (57%), enrolled in Medicaid around the time of diagnosis; the remainder had been enrolled at least 3 months before diagnosis. Persons enrolled at diagnosis had later-stage cancer; those enrolled before diagnosis had more noncancer comorbidities. Overall, 18% had disenrolled by 6 months after diagnosis; 34% by 1 year; and 54% by 2 years. Conclusions: Medicaid patients with cancer in Washington State experience a high rate of disenrollment within 1 year after diagnosis. Further research is needed to determine whether disenrollment compromises initial therapy or follow-up care.