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Impact of Patient Protection and Affordable Care Act and Medicaid expansion on a cancer prevention program
As part of the Cancer Prevention Education Screening and Treatment (CPEST) program, the Baltimore City Health Department (BCHD) offers free colorectal cancer screening for Baltimore City residents who do not have insurance. On January 1, 2014, the health insurance exchange and Medicaid expansion were enacted under the Patient Protection and Affordable Care Act (PPACA), increasing the number of insured Baltimore residents.
Purpose
The purpose of this project was to analyze the impact of the PPACA and Medicaid expansion on enrollees of the CPEST program and to assess the demographics of the target population for the program post PPACA.
Methods
Descriptive statistical analysis was completed on the number and demographics of the clients (n=785) of the CPEST program at the BCHD between the two time periods: July1, 2013 to December 31, 2013 and January 1, 2014 to June 30, 2014.
Results
The total number of the clients decreased by 40% and showed a statistically significant difference (z=-11.24) between the two time periods. The colorectal cancer screening discharge rate showed a statistically significant difference (p=0.0002) between the two time periods. There was no significant difference in the ethnicity, zip code, screening type, and final diagnosis. Conversely, there was an increase in both the female (p=0.033) and the older age groups (p=0.0011) since January 1, 2014.
Conclusion
PPACA and Medicaid expansion dramatically decreased enrollment in the CPEST colorectal cancer screening program. Future recruitment for the program should be targeted towards the population with similar demographics of the clients enrolled from January 1, 2014.
Learning Areas:
Administer health education strategies, interventions and programsConduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Program planning
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Learning Objectives:
Analyze the impact of the Patient Protection and Affordable Care Act and Medicaid expansion on enrollees of a cancer screening program.
Assess the demographics of the target population for a cancer screening program post Patient Protection and Affordable Care Act.
Keyword(s): Cancer Prevention and Screening, Medicaid
Qualified on the content I am responsible for because: I am a graduate student working with a cancer prevention program. My study focus is on health policy with interests in epidemiology of chronic disease and data analysis.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.