Medicaid Expansion Improved Outcomes in Biliary Tract Cancer

The expansion of Medicaid positively impacted survival for patients undergoing surgical and multimodal treatment for stage 1-3 biliary tract cancer, according to findings published in the Journal of Surgical Oncology. Timothy Pawlik, MD, PhD, MPH, and colleagues the effect of Medicaid expansion on multimodal care, including surgery, for patients with stages 1-3 biliary tract cancer. They analyzed data from 12,415 patients diagnosed between 2008-2012, before Medicaid expansion, and 2015-2018, after Medicaid expansion. In states that expanded Medicaid, overall use of surgery and multimodal therapy increased (OR for both, 1.13). Surgery rates rose notably for patients who were uninsured or on Medicaid in states with Medicaid expansion (Δ+10.1%; P= 0.01). Multimodal treatment also increased for this group (Δ+6.4%; P= 0.04). There were no significant changes for other insurance statuses. Patients who were uninsured or on Medicaid in states that expanded Medicaid had a lower long-term risk for death following expansion (HR, 0.81; P=0.03).