Cancer care good under managed care, study shows

Wider adoption of managed care as a way to keep down health care costs has minimal effects on the quality of treatment for cancer patients, according to a new report.

"Other studies have shown that managed care market share is associated with decreased spending on health care services," Dr. Nancy L. Keating from Harvard Medical School, Boston, told Reuters Health. "This paper shows that poorer quality for cancer care - as measured by the quality indicators we used - does not explain these spending differences."

To see if increases in managed care were associated with the quality of cancer care, Keating her and colleagues focused on patients with breast cancer and colorectal cancer.

They found little evidence that care was skimped when managed care became more common. For example, mammography rates and the number of women who received radiation after breast-conserving surgery did not change with the change in managed care market share, the team reports in the Journal of the National Cancer Institute.

Also, among patients with early colorectal cancer, managed care market share was not associated with colonoscopy before or around the time of operation for colorectal cancer or with surveillance colonoscopy from 7 through 18 months after diagnosis.

"Many have been very concerned that managed care is bad for patients," Keating concluded. "Our data suggest that, at least for the cancers we studied, managed care may be able to decrease spending in fee-for-service settings without hindering quality."

SOURCE: Journal of the National Cancer Institute, February 16, 2005.