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Medicare Advantage enrollment was linked to poorer cancer survival despite similar adherence to treatment guidelines.
A study published in June 2025 issue of Annals of Surgery explored how cancer care and outcomes may differ between individuals enrolled in Medicare Advantage (MA) and those enrolled in Traditional Medicare (TM).
Researchers conducted a retrospective study to examine the impact of Medicare insurance status on the quality of care and survival outcomes in individuals diagnosed with cancer.
They identified Medicare beneficiaries in California who received treatment for stage 1–4 of lung, esophageal, gastric, pancreatic, colon, and rectal cancer between 2000 and 2019. Access to care, timeliness of treatment, adherence to clinical guidelines, and overall survival were compared between individuals enrolled in MA and those in TM.
The results showed that 1,70,537 Medicare beneficiaries were included (62,161 lung, 5,518 esophageal, 6,856 gastric, 11,582 pancreatic, 66,742 colon, and 17,678 rectal cancers). Compared to TM, those in MA were equally or more often provided guideline-concordant care for certain cancers. However, MA enrollment was linked to poorer overall survival after adjustment for covariates across all cancer types (HR 1.03, 95%CI 1.02–1.04, P<0.001), with more pronounced associations for lung (HR 1.04, 95% CI 1.02–1.06, P<0.001) and pancreatic (HR 1.10, 95% CI 1.05–1.15, P<0.001) cancers. Survival outcomes were notably worse among individuals with stage 4 cancer (HR 1.05, 95% CI 1.03–1.08, P<0.001).
Investigators concluded that MA enrollment was linked to reduced access to accredited cancer centers and lower survival rates in lung and pancreatic cancer, especially among those with stage 4 disease, despite comparable adherence to guideline-based care.
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