{"doi":"10.1111/jgs.19391","title":"Use of Nursing Homes Among Medicaid Beneficiaries Newly Diagnosed With Cancer","abstract":"Individuals with cancer may transition their care into a nursing home for rehabilitation after a hospitalization, support for functional decline, and lack of social support, or end-of-life care [1]. Much of the prior literature has focused specifically on care transitions among nursing home residents with cancer at the end of life [2-4]. However, less is known about transitions of care into the nursing home among Medicaid beneficiaries. This is an important population to study because they often have intensive care needs and high healthcare costs [5]. In particular, their entry into a nursing facility may be limited due to barriers related to inadequate access to necessary resources, such as palliative care consultation, and payment concerns related to the coverage of chemotherapy drugs by Medicare among those who are dual eligible for both Medicare and Medicaid [6]. To address this gap in the literature, this study quantifies nursing home use among Medicaid beneficiaries newly diagnosed with cancer. This cross-sectional study used the Minimum Data Set 3.0 to identify nursing home resident assessments and Transformed Medicaid Statistical Information System Analytic Files (TAF) to identify Medicaid claims in 45 states (2016–2019). We identified beneficiaries newly diagnosed with cancer in 2017 or 2018 who had continuous Medicaid coverage for at least 6 months prior to their diagnosis (Data S1). We categorized nursing home use and the characteristics of Medicaid beneficiaries newly diagnosed with cancer into groups based on those (1) with no nursing home use during the study period; (2) nursing home use prior to their cancer diagnosis but not after; (3) nursing home use before and after their cancer diagnosis; and (4) nursing home use for the first time after their new cancer diagnosis. For new nursing home users, we also assessed the prevalence of each cancer type among short-stayers (stay less than 90 days) and long-stayers (stay greater than 90 days). This cross-sectional study was approved as exempt by the Harvard Medical School Institutional Review Board. We followed the STROBE reporting guideline. All analyses were conducted in Stata, version 18. We identified 338,767 Medicaid beneficiaries who were newly diagnosed with cancer (Table 1). Most of the sample (n = 270,744; 79.9%) had no nursing home use during the study period, with 3.8% (n = 12,777) who had a nursing home stay prior to their cancer diagnosis but not afterward and 5.4% (n = 18,224) with a nursing home stay before and after their cancer diagnosis. New nursing home users with cancer (n = 37,022, 10.9%) had an average age of 68.6 years, 68.6% dual-eligible, 51.2% White race, and 20.9% Black race. On average, they entered the nursing home within 7.7 months of their new cancer diagnosis, and 12.1% became long-stayers. The mean age of those with no nursing home use (58.8 years) was much lower than that of those with any type of nursing home use. The most prevalent cancer types associated with both short-and long-stay nursing home residents were similar: lung (18.0% vs. 15.5%), breast (9.9% vs. 12.9%), and hematological (9.9% vs. 9.6%) (Figure 1). One in seven Medicaid beneficiaries received care at a nursing home following a new cancer diagnosis, with more than half of these individuals using one for the first time. These beneficiaries were older, more likely to be White or Black race, and dual eligible compared to those who did not use a nursing home and primarily had short nursing home stays. In particular, the high prevalence of nursing home use among dual-eligible beneficiaries who were newly diagnosed with cancer has important policy concerns because chemotherapy is currently not covered under a Medicare Part A skilled nursing facility stay [6], and thus creates a financial burden to care for cancer patients—both for the nursing facility, which does not have to cover the costs of chemotherapy, and for short-stay patients, who face a major coverage gap. Study l","journal":"Journal of the American Geriatrics Society","year":2025,"id":562821,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9516,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":316545,"name":"David C. Grabowski","orcid":"0000-0003-2915-5770","position":1,"is_corresponding":false},{"id":1079883,"name":"Amanda Chen","orcid":"0000-0003-3933-8570","position":0,"is_corresponding":true}],"reference_count":6,"raw_metadata":null,"created_at":"2026-07-19T02:56:09.638214Z","pmid":"40037798","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}