188203 Is Medicaid Enough? A National Evaluation of Cervical Cancer Prevention Services Provided under Medicaid

Wednesday, October 29, 2008

Laurén Doamekpor, MPH , Department of Family Science, School of Public Health University of Maryland – College Park, College Park, MD
Marisa Cox, MA , Department of Health Policy, George Washington University, Washington, DC, DC
Alexandra Stewart, JD , Department of Health Policy, George Washington University, Washington, DC, DC
Objective: Low-income women experience higher mortality rates of cervical cancer and are diagnosed at more advanced disease stages when compared to their high-income counterparts. Medicaid is the largest health insurance program that provides health care for more than 20 million low-income individuals. This study compared how state programs address cervical cancer prevention for adult beneficiaries, and identified gaps in coverage.

Methods: The Department of Health Policy/Kaiser Family Foundation State Survey of Reproductive Health Services under Medicaid study is a national study that included data from 1999 and 2007. Medicaid programs were surveyed and data regarding coverage of Pap tests, Pap labs and the HPV vaccine for adults were collected and analyzed. 36 state responses were compared to 1999 responses and analyzed for trends and changes in coverage.

Results: Results indicate that coverage of Pap tests and Pap labs is generally uniform; little has changed since 1999, and family planning designations are utilized to varying degrees. Of the 36 reporting states, 22 states report the existence of waiver programs, of which 18 provide coverage of Pap smears and Pap labs under their waiver programs. 22 states currently cover the vaccine for adult women, and 8 states have excluded coverage of the vaccine for adults.

Conclusions: Although traditional prevention methods are preserved, coverage of the Pap test and Pap lab service are not fixed firmly under family planning designations. In addition, the degree to which the HPV vaccine is covered leaves room for states to address comprehensive coverage of cervical prevention services.

Learning Objectives:
Participants will be able to: 1. Recognize the significance of cervical cancer prevention services under Medicaid. 2. Understand how Medicaid addresses cervical cancer prevention services, the role of family planning, and how this information will inform policy makers as they consider the adoption of strategies to decrease cervical cancer mortality rates.

Keywords: Medicaid, Cervical Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I will be receiving my MPH in Prevention and Community Health with a concentration in Maternal and Child Health. I have conducted public health since January 2007, and have contributed to the preparation of presentations for a variety of institutions and universities concerning immunization legislation and women’s health, such as The Congressional Hispanic Caucus Institute, and The National Cancer Institute. The project to be presented is part of a Kaiser research study entitled "George Washington University/Kaiser Family Foundation State Survey of Reproductive Health Services under Medicaid" conducted by GWU researchers, of which I played an integral role. In addition as a researcher, I have identify and maintain all current research worldwide on immunization practices, engage in the research and discourse on immunization law, domestic and global vaccine policies.
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.

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