{"doi":"10.1200/op.24.00268","title":"Association Between Medicaid Coverage Continuity and Survival in Patients With Newly Diagnosed Pediatric and Adolescent Cancers","abstract":"PURPOSE Many patients with cancer do not gain Medicaid coverage until a cancer diagnosis, which can reduce access to early cancer detection and timely treatment, potentially driving inferior survival. Little is known about whether continuous Medicaid coverage prediagnosis through postdiagnosis ( v gaining Medicaid at/after diagnosis) provides survival benefits for pediatric/adolescent oncology patients. MATERIALS AND METHODS We identified patients newly diagnosed with cancer at age 21 years or younger in a large pediatric health system between 2007 and 2016. Electronic medical records (EMRs) were linked to Medicaid administrative data to differentiate insurance continuity patterns during the 6 months preceding through the 6 months after cancer diagnosis (assessment window): continuous Medicaid, newly gained Medicaid (at or after diagnosis), and other Medicaid enrollment patterns. For patients not linked to Medicaid data, we used EMR-reported insurance types at diagnosis. We followed patients from 6 months postdiagnosis up to 5 years, death, or December 2020, whichever came first. Multivariable regressions estimated all-cause and cancer-specific survival, controlling for sociodemographic and cancer-related factors. RESULTS Among 1,800 patients included in the analysis, 1,293 (71.8%) had some Medicaid enrollment during the assessment window; among them, 47.6% had continuous Medicaid and 36.3% had newly gained Medicaid. Patients not linked with Medicaid data had private (26.9%) or other/no insurance (1.2%) at diagnosis. Compared with patients with continuous Medicaid, those with newly gained Medicaid had higher risks of all-cause death (hazard ratio [HR], 1.41 [95% CI, 1.10 to 1.81]; P = .008) and cancer-specific death (HR, 1.46 [95% CI, 1.12 to 1.90]; P = .005). CONCLUSION Continuous Medicaid coverage throughout cancer diagnosis is associated with survival benefits for pediatric/adolescent patients. This finding has critical implications as millions of American individuals have been losing coverage since the unwinding of the Medicaid Continuous Enrollment Provision.","journal":"JCO Oncology Practice","year":2024,"id":474162,"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":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9467,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":282785,"name":"Sharon M. Castellino","orcid":"0000-0001-8367-2002","position":1,"is_corresponding":false},{"id":85398,"name":"Anne C. Kirchhoff","orcid":"0000-0002-0747-9179","position":2,"is_corresponding":false},{"id":935183,"name":"Rebecca Williamson Lewis","orcid":"0000-0003-1722-0547","position":3,"is_corresponding":false},{"id":378712,"name":"Nicholas P. DeGroote","orcid":"0009-0000-5056-1699","position":4,"is_corresponding":false},{"id":1298543,"name":"Patricia Daniels Cornwell","orcid":null,"position":5,"is_corresponding":false},{"id":475102,"name":"Ann Mertens","orcid":"0000-0002-1649-4311","position":6,"is_corresponding":false},{"id":515592,"name":"Joseph Lipscomb","orcid":null,"position":7,"is_corresponding":false},{"id":404217,"name":"Xu Ji","orcid":"0000-0003-3025-3984","position":8,"is_corresponding":false},{"id":532244,"name":"Xin Hu","orcid":"0000-0003-1097-3300","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":null,"created_at":"2026-07-19T02:06:09.108857Z","pmid":"39348628","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":[]}