Many stakeholders in healthcare have one common goal: providing quality care to patients who need it. Having access to health insurance is key for improving patient access to much needed care.
The state of Massachusetts (MA) serves as a unique example of how when insurance coverage expands, care improves. Colorectal cancer is the third most common cancer and the third leading cause of cancer-related deaths among adults in the United States. In a recent study, after the state expanded access to health insurance, patients with colorectal cancer, in MA were more likely than patients in other states to get the needed surgery before their conditions worsened. The lead author, who worked on the study, Dr. Andrew Loehrer, says the study “provides cautiously optimistic evidence that expanding insurance doesn’t just increase access to healthcare but also increases the receipt of care and optimal care for a common cancer.”
Overall, lack of insurance coverage has been shown to be associated with:
• more advanced disease at presentation,
• more emergent admissions at time of treatment, and
• lower survival compared to privately insured patients
As a result of the Affordable Care Act (ACA), many states have insurance marketplaces (state-based or access to the Federal marketplace), coverage is mandated, and many states have expanded their Medicaid programs. This increase in insurance access through the ACA and Medicaid expansion, improves access to care, which in turns improves access to treatment. With more insurance expansion expected, this creates an opportunity for our clients to make sure that consumers have access to innovative medical technologies that are part of critical therapies.
GIRS works with commercial payers as well as Medicare and Medicaid to secure coverage and payment for cancer therapies and diagnostics which are key to early diagnosis and access to treatment. We have identified effective reimbursement strategies for radiopharmaceuticals for early identification and staging of cancers and improved patient access to cancer therapies by educating payers and supporting accounts with benefit verifications and appeals services. We have improved patient access to cancer therapies and diagnostics one patient at a time. Let us assist you. Contact Us.