A new study reveals that one in every Medicaid beneficiary who has recently been diagnosed with cancer has been receiving care in nursing homes, and more than half of these individuals were using nursing homes for the first time.
This population of residents often has high needs and high medical costs. Therefore, in order for nursing homes to ensure low-restrictive care, they must be fully equipped to meet specific needs, said Dr. Amanda C. Chen, a researcher at Harvard University.
“Cancer residents may have specific clinical and care needs that are different from other residents. And potential differences in vision and needs can vary depending on whether they are admitted to a nursing home after an acute hospitalization or are recognized by the community,” Chen told McKnight's on Wednesday.
These needs may include access to services, such as palliative care consultations, infusion chemotherapy or other chemotherapy drugs, care coordination, and other rehabilitation services.
Entrance to skilled nursing facilities for such patients may be limited. This is featured in the American Gerontology Association's Journal and co-authored by David C. Grabowski of Harvard.
For example, chemotherapy drugs are not covered within the Medicare part-time area of SNF stays.
It “creates both financial burdens for caring for cancer patients — nursing facilities that do not need to cover the costs of chemotherapy, and short-term stay patients facing major coverage gaps,” the researchers wrote.
Using data from the minimum dataset 3.0, Chen and Grabowski transformed Medicaid Statistics System analysis files to determine survey groups, and analyzed nearly 340,000 claims between 2016 and 2019.
Approximately 80% of newly diagnosed Medicaid patients had no nursing home use during the study period, but nearly 4% had stayed in nursing homes before (but not) cancer diagnosis, and about 5% had stayed in nursing homes before and after cancer diagnosis.
Chen said future research should focus on a deeper understanding of the quality of care for nursing home residents with cancer.
“Is it more difficult for cancer patients to find nursing homes to receive care? Are they receiving care from low-quality nursing homes?” asked Chen. “What are the characteristics of nursing homes with a large share of cancer patients? Will receiving care from one of these nursing homes lead to better outcomes?”
Compared to recently diagnosed patients who did not use nursing homes, Medicaid recipients were older and had long nursing home stays.
We observed that the top five cancers account for the longest and longest nursing home stays.
