Clinical trial · Observational

Assessing Community Cancer Care After Insurance ExpanSionS

NCT02936609CI-TRIAL-00058135ACCESScompletedClinicalTrials.gov clinicaltrialsPublishedExplore in graph →

Summary

Brief summary (as posted)

This innovative and timely study will measure the impact of Affordable Care Act (ACA) Medicaid expansions on cancer screenings and preventive services. To assess this natural policy experiment, the investigators will use electronic health record data from the Accelerating Data Value Across a National Community Health Center Network (ADVANCE) clinical data research network (CDRN) of the National Patient-Centered Clinical Research Network (PCORnet).

Conditions

Conditions (1)

Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.

Condition (as posted)	Mapped entity	Match	Confidence
Cancer	Malignant Neoplasm	ALIAS	0.90

Interventions

Interventions (1)

Intervention	Type	Mapped drug	Match
Medicaid Expansion	Other	—	UNRESOLVED

Design

Arms and outcomes

Arms (2)

label
Medicaid Expansion States
description
Patients receiving care in community health centers in states that expanded Medicaid (intervention group)
interventionNames
1. Other: Medicaid Expansion
label
Medicaid Non-Expansion States
description
Patients receiving care in community health centers in states that did not expand Medicaid (control group)
interventionNames
1. Other: Medicaid Expansion

Primary outcomes (1)

measure
Change in number of preventive services received
timeFrame
Less than or equal to 24 months prior to Medicaid expansion vs greater than or equal to 24 months post
description
Preventive services and screenings for cervical, colorectal, and breast cancers, HPV vaccinations, smoking screening ad interventions, and obesity screening and interventions.

Eligibility

Eligibility (as posted)

Sex: All
Minimum age: 19 Years
Maximum age: 64 Years

Show eligibility criteria text

Inclusion Criteria:

* Patients in intervention and control states aged 19-64

Exclusion Criteria:

* Patients at intervention and control clinics outside of the age range 19-64

References

Publications (6)

RESULTBailey SR, Marino M, Ezekiel-Herrera D, Schmidt T, Angier H, Hoopes MJ, DeVoe JE, Heintzman J, Huguet N. Tobacco Cessation in Affordable Care Act Medicaid Expansion States Versus Non-expansion States. Nicotine Tob Res. 2020 May 26;22(6):1016-1022. doi: 10.1093/ntr/ntz087. PMID 31123754
RESULTHoopes M, Schmidt T, Huguet N, Winters-Stone K, Angier H, Marino M, Shannon J, DeVoe J. Identifying and characterizing cancer survivors in the US primary care safety net. Cancer. 2019 Oct 1;125(19):3448-3456. doi: 10.1002/cncr.32295. Epub 2019 Jun 7. PMID 31174231
RESULTHoopes M, Voss R, Angier H, Marino M, Schmidt T, DeVoe JE, Soule J, Huguet N. Assessing Cancer History Accuracy in Primary Care Electronic Health Records Through Cancer Registry Linkage. J Natl Cancer Inst. 2021 Jul 1;113(7):924-932. doi: 10.1093/jnci/djaa210. PMID 33377908
RESULTHuguet N, Angier H, Rdesinski R, Hoopes M, Marino M, Holderness H, DeVoe JE. Cervical and colorectal cancer screening prevalence before and after Affordable Care Act Medicaid expansion. Prev Med. 2019 Jul;124:91-97. doi: 10.1016/j.ypmed.2019.05.003. Epub 2019 May 8. PMID 31077723
RESULTAngier HE, Marino M, Springer RJ, Schmidt TD, Huguet N, DeVoe JE. The Affordable Care Act improved health insurance coverage and cardiovascular-related screening rates for cancer survivors seen in community health centers. Cancer. 2020 Jul 15;126(14):3303-3311. doi: 10.1002/cncr.32900. Epub 2020 Apr 15. PMID 32294251
DERIVEDAngier H, Huguet N, Marino M, Mori M, Winters-Stone K, Shannon J, Raynor L, Holderness H, DeVoe JE. Assessing Community Cancer care after insurance ExpanSionS (ACCESS) study protocol. Contemp Clin Trials Commun. 2017 Sep;7:136-140. doi: 10.1016/j.conctc.2017.06.011. Epub 2017 Jun 24. PMID 29473059