Quality, Cost, and Timeliness of Cancer Treatment in Medicare Advantage and Traditional Medicare

作者：Aaron P. Mitchell, Stacie B. Dusetzina, Akriti Mishra Meza, Gallagher Gt, Patrick Augello, Hannah Fuchs, Gabrielle Guzman, Abdullah Abdelaziz, Sara Tabatabai, Sonia Persaud, Nirjhar Chakraborty, V. S. Blinder, Andrew S. Epstein, Bobby Daly, William A. Wood, Aaron N. Winn, Mithat Gönen, Jeah Jung · 发表于：JAMA Internal Medicine · 年份：2026 · DOI：10.1001/jamainternmed.2026.2864 · 研究领域：Economic and Financial Impacts of Cancer、Global Cancer Incidence and Screening、Health Systems, Economic Evaluations, Quality of Life

Importance: Use of Medicare Advantage (MA) insurance has been associated with lower cancer treatment costs than traditional Medicare (TM). Whether there are differences in guideline-concordant care or treatment costs for beneficiaries insured under MA vs TM is unknown. Objective: To assess whether Medicare insurance type is associated with receipt of optimal cancer treatment and costs. Design, Setting, and Participants: Retrospective cohort study of a population-based sample using Medicare claims and encounter data from 2015 through 2019. Participants were Medicare beneficiaries with continuous enrollment in either MA or TM and an incident cancer diagnosis from 2016 through 2019. Included patients were those with cancer treatment scenarios (eg, metastatic melanoma, adjuvant therapy for stage III colon cancer) that had substantial variation in the costs of recommended treatment options. Data were analyzed from April 2025 to March 2026. Exposures: Medicare insurance type of MA or TM. Main Outcomes and Measures: The pharmacologic cancer treatment among the available options each patient initiated was analyzed using Medicare data. Each patient's treatment was linked by diagnosis date to contemporary National Comprehensive Cancer Network Guidelines recommendations and Medicare reimbursement rates to ascertain the coprimary outcomes whether a patient received the optimal treatment for their cancer type and the anticipated cost of the initiated treatment. The association of outcomes...