MANAGED CARE April 1999. ©1999 Stezzi Communications
Women who are enrolled in Medicare HMOs and who are diagnosed with breast cancer are more likely to be diagnosed at an earlier stage than women covered by fee-for-service Medicare, according to research in the Journal of the American Medical Association. A National Cancer Institute/Health Care Financing Administration study of 22,000 women with breast cancer shows that 10.8 percent of fee-for-service beneficiaries were diagnosed at late stages, compared with 7.6 percent of HMO enrollees. Differences in early-stage detection rates were statistically insignificant.
The authors, who were careful to refrain from claiming that managed care is superior to fee-for-service medicine, noted that early-diagnosis rates varied widely among HMOs. However, researchers examined records of women who were diagnosed between 1988 and 1993 — a time when most plans did not yet adhere to National Committee for Quality Assurance standards that suggest regular screening mammograms for enrollees.