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SSO 2022 Press Release – The Hidden Costs of Medicare Advantage: Association with Limited Access to High-volume Complex Cancer Surgery and Detriment in Long-term Survival

(Dallas—March 12, 2022, 8:29 a.m.) — Compared to traditional Medicare, Medicare Advantage enrollment was associated with a lower probability of surgery at high volume center for lung, esophagus, stomach, or pancreas resection and Medicare Advantage enrollment was associated with worse overall survival for lung, stomach, or pancreas resections, according to research presented today at Society of Surgical Oncology 2022 International Conference on Surgical Care.

Over the last two decades, the popularity of Medicare Advantage plans has increased with more than a third of older (65 years and greater) Americans now enrolled in them. In contrast to traditional Medicare Medicare Advantage plans control costs by limiting utilization to certain contracted, in-network providers and by requiring prior authorization for specialist referrals

Our prior work identified significant gaps in Medicare Advantage plan coverage for high-volume cancer surgery,” said Kevin M. Sullivan, M.D., City of Hope, Duarte, Calif.  Sullivan and his team sought to compare the impact of Medicare Advantage enrollment with traditional Medicare on acess to high-volume complex cancer surgery and long-term overall survival (OS).

Sullivan’s research team performed a retrospective analysis from 2000-2012 using the Office of Statewide Health Planning Inpatient Database linked to the California Cancer Registry. Patients 65 years or older, undergoing elective inpatient curative-intent cancer surgery for stage 1-3 cancers of the lung, esophagus, stomach, pancreas, colon, and rectum were included

The researchers found a total of 67,580 Medicare beneficiaries met inclusion criteria comprising 14,545 lung resections, 1,833 esophagectomies, 3,567 gastrectomies, 2,132 pancreatectomies, 36,336 colectomies, and 9,167 proctectomies.

Compared to traditional Medicare, Medicare Advantage beneficiaries undergoing lung, esophagus, stomach, and pancreas resections were significantly less likely to have surgery at a high-volume center and Medicare Advantage beneficiaries had worse overall survival compared to traditional Medicare when undergoing lung (hazard ratio [HR] 1.07; p=0.002), stomach (HR 1.12; p=0.035), and pancreas (HR 1.12; p=0.01) resections.

“Based on these findings, access to high volume complex cancer surgery should be prioritized in MA plans,” Dr. Sullivan reported.

About the Society of Surgical Oncology

The Society of Surgical Oncology is a dynamic global community of cancer surgeons shaping advancements in the profession to deliver the highest quality surgical care for cancer patients. SSO promotes leading-edge research, quality standards and knowledge exchange, connecting cancer surgeons worldwide to continuously improve cancer outcomes. Our highly regarded educational resources, the Society’s clinical journal, Annals of Surgical Oncology and events, including SSO 2022 – International Conference on Surgical Cancer Care, inspire members and spur each cancer surgeon to grow, improve and thrive.

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