title: Impact of chronic conditions on the cost of cancer care for Medicaid beneficiaries.
abstract: BACKGROUND
  No study has assessed the cost of treating adult Medicaid cancer patients with preexisting chronic conditions. This information is essential for understanding the cost of cancer care to the Medicaid program above that expended for other chronic conditions, given the increasing prevalence of chronic conditions among cancer patients.
  
  
  METHODS
  We used administrative data from 3 state Medicaid programs' linked cancer registry data to estimate cost of care during the first 6 months following cancer diagnosis for beneficiaries with 4 preexisting chronic conditions: cardiac disease, respiratory diseases, diabetes, and mental health disorders. Our base cohort consisted of 6,212 Medicaid cancer patients aged 21 to 64 years (cancer diagnosed during 2001-2003) who were continuously enrolled in fee-for-service Medicaid for 6 months after diagnosis. A subset of these patients who did not die during the 6-month follow-up (n=4,628), were matched with 2 non-cancer patients each (n=8,536) to assess incremental cost of care.
  
  
  RESULTS
  The average cost of care for cancer patients with the chronic conditions studied was higher than for cancer patients without any of these conditions. The increase in cancer treatment cost associated with the chronic conditions ranged from $4,385 for cardiac disease to $11,009 for mental health disorders.
  
  
  CONCLUSIONS
  Chronic conditions, especially the presence of multiple conditions, are associated with a higher cost of care among Medicaid cancer patients, and these increased costs should be reflected in projections of future Medicaid cancer care costs. The implementation of better care-management processes for cancer patients with preexisting chronic conditions may be one way to reduce these costs.
authors.affiliation: RTI International.
authors.forename: Sujha
authors.initials: S
authors.lastname: Subramanian
authors.affiliation: Centers for Disease Control and Prevention.
authors.forename: Florence K L
authors.initials: FK
authors.lastname: Tangka
authors.affiliation: Centers for Disease Control and Prevention.
authors.forename: Susan A
authors.initials: SA
authors.lastname: Sabatino
authors.affiliation: Rollins School of Public Health Emory University.
authors.forename: David
authors.initials: D
authors.lastname: Howard
authors.affiliation: Centers for Disease Control and Prevention.
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Richardson
authors.affiliation: RTI International.
authors.forename: Susan
authors.initials: S
authors.lastname: Haber
authors.affiliation: RTI International.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Halpern
authors.affiliation: RTI International.
authors.forename: Sonja
authors.initials: S
authors.lastname: Hoover
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000191:economics / Q000453:epidemiology*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid / Q000191:economics* / Q000706:statistics & numerical data; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics* / Q000453:epidemiology; D012042:Registries / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Medicaid; chronic disease; healtchcare costs