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width="1.25rem" xmlns="http://www.w3.org/2000/svg"><polyline points="6 9 6 2 18 2 18 9"></polyline><path d="M6 18H4a2 2 0 0 1-2-2v-5a2 2 0 0 1 2-2h16a2 2 0 0 1 2 2v5a2 2 0 0 1-2 2h-2"></path><rect x="6" y="14" width="12" height="8"></rect></svg></a></button></div></div><div><div class="flex flex-wrap"><p class=" text-primary font-semibold">News</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1"></div><p class=" text-primary font-semibold">Article</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1 "></div><time class="text-gray-500 " dateTime="2025-02-07T22:00:36.087">February 7, 2025</time></div><h1 class="text-[26px] font-medium leading-8">Medicaid Unwinding Left Thousands of Pediatric Patients Uninsured</h1><div class="py-3 text-gray-600 md:flex flex-col md:justify-between"><div class="flex flex-col xs:flex-row"><p class="mr-1 self-start">Author(s):</p><div class="flex flex-col xs:flex-row mb-3 md:mb-0"><div class="flex flex-wrap"><span class="text-md mr-2"><a class="text-author text-gray-500 hover:text-primary underline hover:no-underline decoration-gray-400" href="/authors/brooke-mccormick">Brooke McCormick</a></span></div></div></div><div class="max-w-full"><div class="flex flex-wrap sm:flex-nowrap items-center w-fit my-2"></div><div class="w-full flex flex-col sm:flex-row justify-between mt-2"><div class="block md:hidden "><div class="mt-2 flex items-center max-w-fit"><button title="Medicaid Unwinding Left Thousands of Pediatric Patients Uninsured" aria-label="facebook" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg viewBox="0 0 64 64" width="32" height="32"><circle cx="32" cy="32" r="31" fill="#3b5998"></circle><path d="M34.1,47V33.3h4.6l0.7-5.3h-5.3v-3.4c0-1.5,0.4-2.6,2.6-2.6l2.8,0v-4.8c-0.5-0.1-2.2-0.2-4.1-0.2 c-4.1,0-6.9,2.5-6.9,7V28H24v5.3h4.6V47H34.1z" fill="white"></path></svg></button><button aria-label="twitter" 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border-gray-400 my-4 "><h3 class="text-primary text-xl font-semibold">Key Takeaways</h3><ul class="list-disc px-8"><li class="py-2 "> The end of continuous Medicaid coverage resulted in over 5.5 million pediatric patients losing insurance, affecting healthcare access. </li><li class="py-2 "> Disenrollment was higher among older children, females, and those with chronic medical conditions, with 8.7% becoming uninsured. </li><li class="py-2 hidden"> American Indian or Alaska Native patients experienced higher disenrollment rates compared to White patients, indicating disparities. </li><li class="py-2 hidden"> The study's limitations include its focus on community-based organizations within the OCHIN network, potentially biasing the sample. </li><li class="py-2 hidden"> Further research is needed to assess the impact of disenrollment on healthcare access, outcomes, and clinic operations for pediatric patients.</li></ul><span class="text-xs font-bold text-primary underline cursor-pointer mt-2 ml-4">SHOW MORE</span></div><p class="py-2 mb-2 text-sm italic text-gray-600">During the unwinding of continuous Medicaid provisions, 8.7% of pediatric patients at community-based health organizations became uninsured, with higher rates among older children, females, and those with chronic medical conditions.</p><div class="py-2"><div class="blockText_blockContent__TbCXh"><p class="pb-2">During the unwinding of continuous Medicaid provisions, thousands of pediatric patients lost coverage and became <a target="_blank" href="https://www.ajmc.com/topic/insurance">uninsured</a>, according to a study published in <em><a rel="nofollow noreferrer noopener" target="_blank" href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2829912">JAMA Network Open</a>.</em><sup class="text-inherit">1</sup></p><p class="pb-2"></p><p class="pb-2">Under the federal COVID-19 Public Health Emergency and the Families First Coronavirus Response Act, states received additional Medicaid funding and were prohibited from removing enrolled patients through eligibility redeterminations. However, continuous coverage ended in April 2023, raising concerns among stakeholders about the impact of unwinding continuous Medicaid coverage on care access and outcomes for pediatric patients.</p><p class="pb-2"></p><p class="pb-2">Medicaid remains crucial for pediatric health, covering at least 40% of children. As of October 2024, Medicaid enrollment had <a rel="nofollow noreferrer noopener" target="_blank" href="https://ccf.georgetown.edu/subtopic/unwinding-phe/">declined</a> by 14.7 million, including over 5.5 million pediatric patients.<sup class="text-inherit">2</sup><strong> </strong>This shift also affected community health centers, which serve 1 in 9 pediatric patients and help systemically marginalized patients overcome barriers to care.<sup class="text-inherit">1</sup></p><p class="pb-2"></p><p class="pb-2">Although research has <a rel="nofollow noreferrer noopener" target="_blank" href="https://www.nachc.org/resource/community-healthcenter-chartbook/">found</a> that 16.7% of adult Medicaid-insured patients seen at these organizations lost coverage during unwinding,<sup class="text-inherit">3</sup> the extent of pediatric disenrollment at community-based health organizations remains unexamined.<sup class="text-inherit">1</sup> Consequently, the researchers investigated the scope of Medicaid disenrollment to uninsured status during unwinding among pediatric patients receiving care at community-based health care organizations.</p><div class=""><div style="width:40%;float:right;max-width:525px;margin:0 0 1.5rem 1.5rem;clear:both;cursor:" class=" figure"><div class="flex-none relative text-center"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%276016%27%20height=%274016%27/%3e"/></span><img alt="Pediatric patient | Image Credit: VadimGuzhva - stock.adobe.com" title="Pediatric patient | Image Credit: VadimGuzhva - stock.adobe.com" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="Pediatric patient | Image Credit: VadimGuzhva - stock.adobe.com" title="Pediatric patient | Image Credit: VadimGuzhva - stock.adobe.com" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F14b79c114bd8ddc384903fda8bfcf19f19cb3e14-6016x4016.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 1x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F14b79c114bd8ddc384903fda8bfcf19f19cb3e14-6016x4016.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div id="image-caption" class="text-gray-500 italic"><div class="blockText_blockContent__TbCXh"><p class="pb-2">During the unwinding of continuous Medicaid provisions, 8.7% of pediatric patients at community-based health organizations became uninsured. | Image Credit: VadimGuzhva - stock.adobe.com</p></div></div><div class="top-[-100%] block w-[1px] transition-opacity duration-500 ease-in-out opacity-0 overflow-hidden"><img class="m-auto absolute inset-0 max-w-[0%] max-h-[0%] border-[3px] border-solid border-white shadow-[0px_0px_8px_rgba(0,0,0,0.3)] box-border transition ease-in-out duration-500" src="https://cdn.sanity.io/images/0vv8moc6/ajmc/14b79c114bd8ddc384903fda8bfcf19f19cb3e14-6016x4016.jpg?fit=crop&auto=format"/></div></div><style> #image-caption p{ font-size: 12px; max-width: 525px; margin: 0 auto; text-align: center; } </style></div><p class="pb-2">They used electronic health record (EHR) data from OCHIN, a nonprofit organization with a fully hosted and shared EHR platform for a nationwide network of community-based health care organizations. These organizations serve patients regardless of their ability to pay. Therefore, they treat a higher proportion of minoritized populations.</p><p class="pb-2"></p><p class="pb-2">The study focused on patients aged 0 months to 17 years as of their last visit during the period when Medicaid coverage was continuous (January 1, 2021, to March 31, 2023) and their first visit during the unwinding period (April 1, 2023, to March 31, 2024). Eligible patients received services from specific health care organizations, like community health centers, rural health centers, and specialty clinics, in states with substantial representation in the OCHIN network.</p><p class="pb-2"></p><p class="pb-2">The primary outcome was Medicaid disenrollment, considered as being insured through Medicaid at the last visit during continuous coverage, and then having at least 1 uninsured visit during the unwinding period. The researchers used logistic regression to estimate the odds of being uninsured during unwinding. Also, Cox proportional hazards regression models were used to examine the time to uninsured status from the start of unwinding in each patient’s state of residence through March 2024. Additionally, they assessed associations between the primary outcome and age, sex, language, race and ethnicity, and medical complexity.</p><p class="pb-2"></p><p class="pb-2">Among 450,146 eligible pediatric patients, the mean (SD) age was 8.11 (5.07) years. More specifically, one-third of patients were aged 6 to 11 years (n = 151,479; 33.7%), and 31,008 were younger than 1 year (6.9%). Also, the researchers analyzed slightly more male patients (n = 225,354; 50.1%) than females (n = 224,747; 49.9%).</p><p class="pb-2"></p><p class="pb-2">As for race and ethnicity, 52.2% (n = 234,901) were Hispanic, 17.6% (n = 79,223) White, 13.8% (n = 60,060) Black, 8.9% (n = 40,076) other or unknown race and ethnicity, 4.9% (n = 22,066) Asian, 1.3% (n = 6048) American Indian or Alaska Native, 1.2% (n = 5381) multiracial, and 0.1% (n = 391) Native Hawaiian or Other Pacific Islander.</p><p class="pb-2"></p><p class="pb-2">Over half of patients preferred care in English (n = 241,555; 53.7%) vs Spanish (n = 176,530; 39.2%). Regarding medical complexity status, 38.8% were classified as nonchronic, 28.1% as chronic but noncomplex, and 33.2% as complex chronic.</p><p class="pb-2"></p><p class="pb-2">Of the study population, 39,294 (8.7%) were disenrolled from Medicaid to uninsured status during the unwinding period. Unadjusted descriptive statistics demonstrated that disenrolled patients tended to be older, have chronic complex medical complexity status, and prefer care in English. Therefore, patients aged 12 to 17 years had the highest estimated disenrollment percentage, at 10.5%.</p><p class="pb-2"></p><p class="pb-2">After adjustment, all other age groups had lower odds of being disenrolled to uninsured status vs those younger than 1. Also, female patients had higher odds of disenrollment (adjusted OR [aOR], 1.15; 95% CI, 1.13-1.18; adjusted HR [aHR], 1.14; 95% CI, 1.12-1.17) compared with male patients, with estimated disenrollment of 9.1% and 8.4%, respectively.</p><p class="pb-2"></p><p class="pb-2">As for race, the researchers found in the adjusted analyses that American Indian or Alaska Native patients (aOR, 1.95; 95% CI, 1.81-2.09; aHR, 1.81; 95% CI, 1.05-3.13) had higher disenrollment compared with White patients, with estimated disenrollment of 17.1% vs 9.4%.</p><p class="pb-2"></p><p class="pb-2">Lastly, patients with chronic but noncomplex (aOR, 1.83; 95% CI, 1.79-1.88; aHR, 1.80; 95% CI, 1.44-2.27) or complex chronic medical complexity (aOR, 1.95; 95% CI, 1.89-2.00; aHR, 1.92; 95% CI, 1.67-2.21) had higher odds and likelihood of disenrollment, with estimated disenrollment rates of 10.2% and 10.4%, respectively, compared with 6.3% among those with nonchronic medical complexity.</p><p class="pb-2"></p><p class="pb-2">The researchers acknowledged their study’s limitations, one being that it only included community-based health care organizations within the OCHIN network. Therefore, it did not capture all patients or all states, representing a potentially biased sample. Despite these limitations, the researchers expressed confidence in their findings, suggesting areas for further research.</p><p class="pb-2"></p><p class="pb-2">“Future work should continue to examine the impact of this disenrollment to uninsured status on patients’ access to care and health outcomes and clinic operations,” the authors concluded.</p><p class="pb-2"></p><p class="pb-2"><strong>References</strong></p><p class="pb-2">1. Bensken WP, Dankovchik J, Fein HL, Duhon G, Sills MR. Unwinding of continuous Medicaid coverage among pediatric community health center patients. <em>JAMA Netw Open.</em> 2025;8(2):e2458155. doi:10.1001/jamanetworkopen.2024.58155</p><p class="pb-2">2. Center for Children and Families. Unwinding continuous coverage. Georgetown University McCourt School of Public Policy. 2024. Accessed February 6, 2025. <a rel="nofollow noreferrer noopener" target="_blank" href="https://ccf.georgetown.edu/subtopic/unwinding-phe/">https://ccf.georgetown.edu/subtopic/unwinding-phe/</a></p><p class="pb-2">3. National Association of Community Health Centers. Community Health Center Chartbook 2024: analysis of 2022 UDS data. March 1, 2024. Accessed February 6, 2025. <a rel="nofollow noreferrer noopener" target="_blank" href="https://www.nachc.org/resource/community-healthcenter-chartbook/">https://www.nachc.org/resource/community-healthcenter-chartbook/</a></p></div></div><div class="flex items-center lg:w-3/4 mb-4 pb-12"></div><div class="jsx-19ede9f0a5a45918 py-4 relative bg-primary md:px-8 -ml-6 xs:ml-0 w-screen xs:w-auto"><div class="jsx-19ede9f0a5a45918 px-4 sm:px-0"><div class="flex justify-between items-center py-1 space-x-4 border-0 select-none sm:border-b border-secondary"><div class="text-3xl text-white text-lg sm:text-3xl">Related Videos</div></div></div><div style="scroll-snap-type:none" class="jsx-19ede9f0a5a45918 flex items-start overflow-x-auto space-x-4 py-4 relative mx-auto w-full pl-4"><a id="" class="w-[200px] h-fit space-y-3 flex-none select-none no-underline" style="scroll-snap-align:center;text-decoration:none" href="/view/geographic-barriers-impede-access-to-novel-cancer-treatments"><div 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mb-2 border border-secondary"></div><div class="lg:hidden flex flex-wrap items-center"></div><div class="flex flex-wrap w-full"><div class="jsx-ad50481d5ee26850 w-full h-full"><div><div><div class="text-[8px] text-center text-gray-500 hidden">Advertisement</div><div id="div-gpt-ad-infeed-1"></div></div></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/trump-endorses-budget-that-would-slash-medicaid-funding?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/ed26226475ed09729d58659b4f69dee0505dbd2a-6000x4000.jpg?fit=crop&auto=format" alt="Medicaid | Image credit: Tada Images - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 20th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/trump-endorses-budget-that-would-slash-medicaid-funding?utm_source=www.ajmc.com&utm_medium=relatedContent">Trump Endorses Budget That Would Slash Medicaid Funding</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/julia-bonavitacola">Julia Bonavitacola</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/trump-endorses-budget-that-would-slash-medicaid-funding?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The House budget includes cutting $880 billion from programs under the House Energy and Commerce Committee's jurisdiction, which include Medicaid.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/varied-access-the-pharmacogenetic-testing-coverage-divide?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/4d74ae04b0508977864936ec08f2aaa199758e5c-1000x563.jpg?fit=crop&auto=format" alt="managed care cast logo" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 18th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/varied-access-the-pharmacogenetic-testing-coverage-divide?utm_source=www.ajmc.com&utm_medium=relatedContent">Varied Access: The Pharmacogenetic Testing Coverage Divide</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/brooke-mccormick">Brooke McCormick</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/jai-n-patel-pharmd">Jai N. Patel, PharmD</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/varied-access-the-pharmacogenetic-testing-coverage-divide?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex md:hidden justify-center items-center"></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/contributor-beyond-a-one-size-fits-all-for-managed-care-plan-benchmarks?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/01de39b3e71277c2b662177e9c1d5249f7cdadb4-1200x686.jpg?fit=crop&auto=format" alt="Apple and oranges | Image Credit: © vivekFx - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 20th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/contributor-beyond-a-one-size-fits-all-for-managed-care-plan-benchmarks?utm_source=www.ajmc.com&utm_medium=relatedContent">Contributor: Beyond a One-Size-Fits-All for Managed Care Plan Benchmarks</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/jarrod-mcnaughton">Jarrod McNaughton</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/edward-juhn-md-mba-mph">Edward Juhn, MD, MBA, MPH</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/contributor-beyond-a-one-size-fits-all-for-managed-care-plan-benchmarks?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Comparing plans with similar characteristics, such as size, geographic location, or demographics served, allows for more meaningful insights and improvement opportunities. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/telemedicine-s-evolution-and-expanding-access-to-obesity-and-specialty-care?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/9de113904a026205cbaf84d08420c4065d52fd67-1000x563.jpg?fit=crop&auto=format" alt="Telemedicine’s Evolution and Expanding Access to Obesity, Specialty Care" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 11th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/telemedicine-s-evolution-and-expanding-access-to-obesity-and-specialty-care?utm_source=www.ajmc.com&utm_medium=relatedContent">Telemedicine’s Evolution and Expanding Access to Obesity, Specialty Care</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/maggie-l-shaw">Maggie L. Shaw</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/george-jones">George Jones</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/telemedicine-s-evolution-and-expanding-access-to-obesity-and-specialty-care?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">George Jones of UpScript Health discusses telemedicine's evolution from basic e-prescribing to real-time video consultations, expanding treatment beyond primary care.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/ovarian-cancer-remission-rates-remained-stable-before-after-covid-19-pandemic?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/b494e9799158e243f77a0a93a8c86b5ea820d210-6908x3933.jpg?fit=crop&auto=format" alt="COVID-19 pandemic illustration | Image Credit: James Thew - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 20th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/ovarian-cancer-remission-rates-remained-stable-before-after-covid-19-pandemic?utm_source=www.ajmc.com&utm_medium=relatedContent">Ovarian Cancer Remission Rates Remained Stable Before, After COVID-19 Pandemic</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/brooke-mccormick">Brooke McCormick</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/ovarian-cancer-remission-rates-remained-stable-before-after-covid-19-pandemic?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The comparable rates of remission pre- and post-pandemic suggest that COVID-19 did not negatively impact the outcomes of patients with ovarian cancer. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/cancer-mortality-rates-still-high-among-black-patients-despite-overall-decline?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/4b1e70c0107d954ccd83281363addeca769a16bd-4992x3328.jpg?fit=crop&auto=format" alt="Patient talking with doctor | Image credit: Monkey Business - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 20th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/cancer-mortality-rates-still-high-among-black-patients-despite-overall-decline?utm_source=www.ajmc.com&utm_medium=relatedContent">Cancer Mortality Rates Still High Among Black Patients, Despite Overall Decline</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/julia-bonavitacola">Julia Bonavitacola</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/cancer-mortality-rates-still-high-among-black-patients-despite-overall-decline?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Black individuals had a 2-fold risk of cancer death related to prostate, myeloma, and stomach cancers compared with White individuals.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div></div></div></div><div class="relative hidden sm:block"><div class="mt-4 overflow-hidden"><div class="flex justify-between"><div class="flex items-center clear-both pt-4 pb-2 text-3xl lg:text-2xl xl:text-3xl min-w-fit ">Related Content </div><div class="hidden lg:flex w-full flex-col justify-end items-end"><div class="hidden w-full lg:flex flex-wrap pb-2 gap-x-2 gap-y-1 justify-end items-end"></div></div></div><div class="w-full mb-2 border border-secondary"></div><div class="lg:hidden flex flex-wrap items-center"></div><div class="flex flex-wrap w-full"><div class="jsx-ad50481d5ee26850 w-full h-full"><div><div><div class="text-[8px] text-center text-gray-500 hidden">Advertisement</div><div id="div-gpt-ad-infeed-1"></div></div></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/trump-endorses-budget-that-would-slash-medicaid-funding?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/ed26226475ed09729d58659b4f69dee0505dbd2a-6000x4000.jpg?fit=crop&auto=format" alt="Medicaid | Image credit: Tada Images - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 20th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/trump-endorses-budget-that-would-slash-medicaid-funding?utm_source=www.ajmc.com&utm_medium=relatedContent">Trump Endorses Budget That Would Slash Medicaid Funding</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/julia-bonavitacola">Julia Bonavitacola</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/trump-endorses-budget-that-would-slash-medicaid-funding?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The House budget includes cutting $880 billion from programs under the House Energy and Commerce Committee's jurisdiction, which include Medicaid.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/varied-access-the-pharmacogenetic-testing-coverage-divide?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/4d74ae04b0508977864936ec08f2aaa199758e5c-1000x563.jpg?fit=crop&auto=format" alt="managed care cast logo" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 18th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/varied-access-the-pharmacogenetic-testing-coverage-divide?utm_source=www.ajmc.com&utm_medium=relatedContent">Varied Access: The Pharmacogenetic Testing Coverage Divide</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/brooke-mccormick">Brooke McCormick</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/jai-n-patel-pharmd">Jai N. Patel, PharmD</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/varied-access-the-pharmacogenetic-testing-coverage-divide?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex md:hidden justify-center items-center"></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/contributor-beyond-a-one-size-fits-all-for-managed-care-plan-benchmarks?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/01de39b3e71277c2b662177e9c1d5249f7cdadb4-1200x686.jpg?fit=crop&auto=format" alt="Apple and oranges | Image Credit: © vivekFx - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 20th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/contributor-beyond-a-one-size-fits-all-for-managed-care-plan-benchmarks?utm_source=www.ajmc.com&utm_medium=relatedContent">Contributor: Beyond a One-Size-Fits-All for Managed Care Plan Benchmarks</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/jarrod-mcnaughton">Jarrod McNaughton</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/edward-juhn-md-mba-mph">Edward Juhn, MD, MBA, MPH</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/contributor-beyond-a-one-size-fits-all-for-managed-care-plan-benchmarks?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Comparing plans with similar characteristics, such as size, geographic location, or demographics served, allows for more meaningful insights and improvement opportunities. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/telemedicine-s-evolution-and-expanding-access-to-obesity-and-specialty-care?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/9de113904a026205cbaf84d08420c4065d52fd67-1000x563.jpg?fit=crop&auto=format" alt="Telemedicine’s Evolution and Expanding Access to Obesity, Specialty Care" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 11th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/telemedicine-s-evolution-and-expanding-access-to-obesity-and-specialty-care?utm_source=www.ajmc.com&utm_medium=relatedContent">Telemedicine’s Evolution and Expanding Access to Obesity, Specialty Care</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/maggie-l-shaw">Maggie L. Shaw</a><span class="jsx-ad50481d5ee26850 mr-1 ml-[1px]"> </span><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/george-jones">George Jones</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/telemedicine-s-evolution-and-expanding-access-to-obesity-and-specialty-care?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">George Jones of UpScript Health discusses telemedicine's evolution from basic e-prescribing to real-time video consultations, expanding treatment beyond primary care.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/ovarian-cancer-remission-rates-remained-stable-before-after-covid-19-pandemic?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/b494e9799158e243f77a0a93a8c86b5ea820d210-6908x3933.jpg?fit=crop&auto=format" alt="COVID-19 pandemic illustration | Image Credit: James Thew - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 20th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/ovarian-cancer-remission-rates-remained-stable-before-after-covid-19-pandemic?utm_source=www.ajmc.com&utm_medium=relatedContent">Ovarian Cancer Remission Rates Remained Stable Before, After COVID-19 Pandemic</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/brooke-mccormick">Brooke McCormick</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/ovarian-cancer-remission-rates-remained-stable-before-after-covid-19-pandemic?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The comparable rates of remission pre- and post-pandemic suggest that COVID-19 did not negatively impact the outcomes of patients with ovarian cancer. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/cancer-mortality-rates-still-high-among-black-patients-despite-overall-decline?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/4b1e70c0107d954ccd83281363addeca769a16bd-4992x3328.jpg?fit=crop&auto=format" alt="Patient talking with doctor | Image credit: Monkey Business - stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">February 20th 2025</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/cancer-mortality-rates-still-high-among-black-patients-despite-overall-decline?utm_source=www.ajmc.com&utm_medium=relatedContent">Cancer Mortality Rates Still High Among Black Patients, Despite Overall Decline</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/julia-bonavitacola">Julia Bonavitacola</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/cancer-mortality-rates-still-high-among-black-patients-despite-overall-decline?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Black individuals had a 2-fold risk of cancer death related to prostate, myeloma, and stomach cancers compared with White individuals.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div></div></div></div><div class="pb-24"></div></div><script type="application/ld+json">{"@context":"https://schema.org","@type":"NewsArticle","headline":"Medicaid Unwinding Left Thousands of Pediatric Patients Uninsured","datePublished":"2025-02-07T22:00:36.087Z","dateModified":"2025-02-07T19:49:17Z","inLanguage":"en-US","image":"https://cdn.sanity.io/images/0vv8moc6/ajmc/14b79c114bd8ddc384903fda8bfcf19f19cb3e14-6016x4016.jpg?fit=crop&auto=format","mainEntityOfPage":{"@type":"WebPage","@id":"https://www.ajmc.com/view/medicaid-unwinding-left-thousands-of-pediatric-patients-uninsured"},"publisher":{"@type":"Organization","name":"AJMC","logo":{"@type":"ImageObject","url":"https://www.ajmc.com/ajmc_logo_inverted.png"}},"keywords":"Medicare,unwinding,COVID-19 pandemic,pediatric patients,community-based health organizations","articleBody":"During the unwinding of continuous Medicaid provisions, thousands of pediatric patients lost coverage and became uninsured, according to a study published in JAMA Network Open.1\n\n\n\nUnder the federal COVID-19 Public Health Emergency and the Families First Coronavirus Response Act, states received additional Medicaid funding and were prohibited from removing enrolled patients through eligibility redeterminations. However, continuous coverage ended in April 2023, raising concerns among stakeholders about the impact of unwinding continuous Medicaid coverage on care access and outcomes for pediatric patients.\n\n\n\nMedicaid remains crucial for pediatric health, covering at least 40% of children. As of October 2024, Medicaid enrollment had declined by 14.7 million, including over 5.5 million pediatric patients.2 This shift also affected community health centers, which serve 1 in 9 pediatric patients and help systemically marginalized patients overcome barriers to care.1\n\n\n\nAlthough research has found that 16.7% of adult Medicaid-insured patients seen at these organizations lost coverage during unwinding,3 the extent of pediatric disenrollment at community-based health organizations remains unexamined.1 Consequently, the researchers investigated the scope of Medicaid disenrollment to uninsured status during unwinding among pediatric patients receiving care at community-based health care organizations.\n\n\n\nThey used electronic health record (EHR) data from OCHIN, a nonprofit organization with a fully hosted and shared EHR platform for a nationwide network of community-based health care organizations. These organizations serve patients regardless of their ability to pay. Therefore, they treat a higher proportion of minoritized populations.\n\n\n\nThe study focused on patients aged 0 months to 17 years as of their last visit during the period when Medicaid coverage was continuous (January 1, 2021, to March 31, 2023) and their first visit during the unwinding period (April 1, 2023, to March 31, 2024). Eligible patients received services from specific health care organizations, like community health centers, rural health centers, and specialty clinics, in states with substantial representation in the OCHIN network.\n\n\n\nThe primary outcome was Medicaid disenrollment, considered as being insured through Medicaid at the last visit during continuous coverage, and then having at least 1 uninsured visit during the unwinding period. The researchers used logistic regression to estimate the odds of being uninsured during unwinding. Also, Cox proportional hazards regression models were used to examine the time to uninsured status from the start of unwinding in each patient’s state of residence through March 2024. Additionally, they assessed associations between the primary outcome and age, sex, language, race and ethnicity, and medical complexity.\n\n\n\nAmong 450,146 eligible pediatric patients, the mean (SD) age was 8.11 (5.07) years. More specifically, one-third of patients were aged 6 to 11 years (n = 151,479; 33.7%), and 31,008 were younger than 1 year (6.9%). Also, the researchers analyzed slightly more male patients (n = 225,354; 50.1%) than females (n = 224,747; 49.9%).\n\n\n\nAs for race and ethnicity, 52.2% (n = 234,901) were Hispanic, 17.6% (n = 79,223) White, 13.8% (n = 60,060) Black, 8.9% (n = 40,076) other or unknown race and ethnicity, 4.9% (n = 22,066) Asian, 1.3% (n = 6048) American Indian or Alaska Native, 1.2% (n = 5381) multiracial, and 0.1% (n = 391) Native Hawaiian or Other Pacific Islander.\n\n\n\nOver half of patients preferred care in English (n = 241,555; 53.7%) vs Spanish (n = 176,530; 39.2%). Regarding medical complexity status, 38.8% were classified as nonchronic, 28.1% as chronic but noncomplex, and 33.2% as complex chronic.\n\n\n\nOf the study population, 39,294 (8.7%) were disenrolled from Medicaid to uninsured status during the unwinding period. Unadjusted descriptive statistics demonstrated that disenrolled patients tended to be older, have chronic complex medical complexity status, and prefer care in English. Therefore, patients aged 12 to 17 years had the highest estimated disenrollment percentage, at 10.5%.\n\n\n\nAfter adjustment, all other age groups had lower odds of being disenrolled to uninsured status vs those younger than 1. Also, female patients had higher odds of disenrollment (adjusted OR [aOR], 1.15; 95% CI, 1.13-1.18; adjusted HR [aHR], 1.14; 95% CI, 1.12-1.17) compared with male patients, with estimated disenrollment of 9.1% and 8.4%, respectively.\n\n\n\nAs for race, the researchers found in the adjusted analyses that American Indian or Alaska Native patients (aOR, 1.95; 95% CI, 1.81-2.09; aHR, 1.81; 95% CI, 1.05-3.13) had higher disenrollment compared with White patients, with estimated disenrollment of 17.1% vs 9.4%.\n\n\n\nLastly, patients with chronic but noncomplex (aOR, 1.83; 95% CI, 1.79-1.88; aHR, 1.80; 95% CI, 1.44-2.27) or complex chronic medical complexity (aOR, 1.95; 95% CI, 1.89-2.00; aHR, 1.92; 95% CI, 1.67-2.21) had higher odds and likelihood of disenrollment, with estimated disenrollment rates of 10.2% and 10.4%, respectively, compared with 6.3% among those with nonchronic medical complexity.\n\n\n\nThe researchers acknowledged their study’s limitations, one being that it only included community-based health care organizations within the OCHIN network. Therefore, it did not capture all patients or all states, representing a potentially biased sample. Despite these limitations, the researchers expressed confidence in their findings, suggesting areas for further research.\n\n\n\n“Future work should continue to examine the impact of this disenrollment to uninsured status on patients’ access to care and health outcomes and clinic operations,” the authors concluded.\n\n\n\nReferences\n\n1. Bensken WP, Dankovchik J, Fein HL, Duhon G, Sills MR. Unwinding of continuous Medicaid coverage among pediatric community health center patients. JAMA Netw Open. 2025;8(2):e2458155. doi:10.1001/jamanetworkopen.2024.58155\n\n2. Center for Children and Families. Unwinding continuous coverage. Georgetown University McCourt School of Public Policy. 2024. Accessed February 6, 2025. https://ccf.georgetown.edu/subtopic/unwinding-phe/\n\n3. National Association of Community Health Centers. Community Health Center Chartbook 2024: analysis of 2022 UDS data. March 1, 2024. Accessed February 6, 2025. https://www.nachc.org/resource/community-healthcenter-chartbook/","description":"During the unwinding of continuous Medicaid provisions, 8.7% of pediatric patients at community-based health organizations became uninsured, with higher rates among older children, females, and those with chronic medical conditions.","author":[{"@type":"Person","name":"Brooke McCormick"}]}</script></div></div><div class="flex-none w-[300px] z-[9999] relative hidden md:block"><div style="top:5rem" class="sticky custom-spacing"><div class="collapse-container " style="overflow:hidden;max-height:900px;transition:max-height .4s ease-in-out"></div></div></div></div><div id="div-gpt-ad-pixel" style="width:1px;height:1px" class=""></div><noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-NK5KQXS" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript><div id="footerOuterWrap" class=" mx-auto flex"><div class="bg-[#00598D] xl:w-[70%] w-[70%] 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A study using OCHIN network data revealed that 8.7% of pediatric patients became uninsured during this period. Disenrollment was more prevalent among older children, females, and those with chronic medical conditions. American Indian or Alaska Native patients faced higher disenrollment rates compared to White patients. 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These organizations serve patients regardless of their ability to pay. Therefore, they treat a higher proportion of minoritized populations."}],"_type":"block","style":"normal","upload_doc":null,"uploadAudio":null,"medias":null,"_key":"cd58f4a6f320","markDefs":[]},{"_type":"block","style":"normal","_key":"2c7a81b9495a","upload_doc":null,"uploadAudio":null,"medias":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"f630e157bb2a"}]},{"uploadAudio":null,"medias":null,"children":[{"_type":"span","marks":[],"text":"The study focused on patients aged 0 months to 17 years as of their last visit during the period when Medicaid coverage was continuous (January 1, 2021, to March 31, 2023) and their first visit during the unwinding period (April 1, 2023, to March 31, 2024). Eligible patients received services from specific health care organizations, like community health centers, rural health centers, and specialty clinics, in states with substantial representation in the OCHIN network.","_key":"9250dfb82ec7"}],"_type":"block","style":"normal","_key":"f45a5db88967","markDefs":[],"upload_doc":null},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"7b496eb74f9a"}],"_type":"block","style":"normal","upload_doc":null,"uploadAudio":null,"medias":null,"_key":"8f8a79ee94c0"},{"upload_doc":null,"uploadAudio":null,"medias":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"The primary outcome was Medicaid disenrollment, considered as being insured through Medicaid at the last visit during continuous coverage, and then having at least 1 uninsured visit during the unwinding period. The researchers used logistic regression to estimate the odds of being uninsured during unwinding. Also, Cox proportional hazards regression models were used to examine the time to uninsured status from the start of unwinding in each patient’s state of residence through March 2024. Additionally, they assessed associations between the primary outcome and age, sex, language, race and ethnicity, and medical complexity.","_key":"fe56f05ad84c"}],"_type":"block","style":"normal","_key":"ced360f568e8"},{"children":[{"marks":[],"text":"","_key":"5cb05a5a8f52","_type":"span"}],"_type":"block","style":"normal","_key":"901f5b2c4544","markDefs":[],"upload_doc":null,"uploadAudio":null,"medias":null},{"upload_doc":null,"uploadAudio":null,"medias":null,"_key":"b36babfb0e2c","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Among 450,146 eligible pediatric patients, the mean (SD) age was 8.11 (5.07) years. More specifically, one-third of patients were aged 6 to 11 years (n = 151,479; 33.7%), and 31,008 were younger than 1 year (6.9%). Also, the researchers analyzed slightly more male patients (n = 225,354; 50.1%) than females (n = 224,747; 49.9%).","_key":"cf1b0c121ee8"}],"_type":"block","style":"normal"},{"style":"normal","_key":"4ec4594eab15","markDefs":[],"children":[{"text":"","_key":"4e6a9eee14bb","_type":"span","marks":[]}],"_type":"block","upload_doc":null,"uploadAudio":null,"medias":null},{"upload_doc":null,"uploadAudio":null,"medias":null,"children":[{"_type":"span","marks":[],"text":"As for race and ethnicity, 52.2% (n = 234,901) were Hispanic, 17.6% (n = 79,223) White, 13.8% (n = 60,060) Black, 8.9% (n = 40,076) other or unknown race and ethnicity, 4.9% (n = 22,066) Asian, 1.3% (n = 6048) American Indian or Alaska Native, 1.2% (n = 5381) multiracial, and 0.1% (n = 391) Native Hawaiian or Other Pacific Islander.","_key":"fbed4db47b77"}],"_type":"block","style":"normal","_key":"3f818efbf364","markDefs":[]},{"children":[{"_type":"span","marks":[],"text":"","_key":"61d36323d3c3"}],"_type":"block","style":"normal","_key":"ec5f1e73adfe","markDefs":[],"upload_doc":null,"uploadAudio":null,"medias":null},{"style":"normal","_key":"15c5a042405e","markDefs":[],"upload_doc":null,"uploadAudio":null,"medias":null,"children":[{"_key":"7da5c37d80db","_type":"span","marks":[],"text":"Over half of patients preferred care in English (n = 241,555; 53.7%) vs Spanish (n = 176,530; 39.2%). Regarding medical complexity status, 38.8% were classified as nonchronic, 28.1% as chronic but noncomplex, and 33.2% as complex chronic."}],"_type":"block"},{"_key":"ab9e8119f916","upload_doc":null,"uploadAudio":null,"medias":null,"markDefs":[],"children":[{"text":"","_key":"cd71e6817d5c","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"_type":"block","upload_doc":null,"uploadAudio":null,"medias":null,"style":"normal","_key":"95630a4af07d","markDefs":[],"children":[{"marks":[],"text":"Of the study population, 39,294 (8.7%) were disenrolled from Medicaid to uninsured status during the unwinding period. Unadjusted descriptive statistics demonstrated that disenrolled patients tended to be older, have chronic complex medical complexity status, and prefer care in English. Therefore, patients aged 12 to 17 years had the highest estimated disenrollment percentage, at 10.5%.","_key":"a0a4c8c88664","_type":"span"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"f24fcde04796"}],"_type":"block","style":"normal","_key":"01a951238ba8","upload_doc":null,"uploadAudio":null,"medias":null},{"medias":null,"_type":"block","style":"normal","_key":"d0bf22eb7d0e","markDefs":[],"children":[{"text":"After adjustment, all other age groups had lower odds of being disenrolled to uninsured status vs those younger than 1. Also, female patients had higher odds of disenrollment (adjusted OR [aOR], 1.15; 95% CI, 1.13-1.18; adjusted HR [aHR], 1.14; 95% CI, 1.12-1.17) compared with male patients, with estimated disenrollment of 9.1% and 8.4%, respectively.","_key":"fc1546b80426","_type":"span","marks":[]}],"upload_doc":null,"uploadAudio":null},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"c179209ddfd3"}],"_type":"block","style":"normal","_key":"b23c19ff01a8","upload_doc":null,"uploadAudio":null,"medias":null},{"_type":"block","style":"normal","_key":"6ba6f8ccfc4f","upload_doc":null,"uploadAudio":null,"medias":null,"markDefs":[],"children":[{"_type":"span","marks":[],"text":"As for race, the researchers found in the adjusted analyses that American Indian or Alaska Native patients (aOR, 1.95; 95% CI, 1.81-2.09; aHR, 1.81; 95% CI, 1.05-3.13) had higher disenrollment compared with White patients, with estimated disenrollment of 17.1% vs 9.4%.","_key":"99c2c50820bb"}]},{"style":"normal","_key":"a51cff2ac82c","markDefs":[],"children":[{"_key":"598596d0e876","_type":"span","marks":[],"text":""}],"_type":"block","upload_doc":null,"uploadAudio":null,"medias":null},{"upload_doc":null,"uploadAudio":null,"medias":null,"children":[{"_type":"span","marks":[],"text":"Lastly, patients with chronic but noncomplex (aOR, 1.83; 95% CI, 1.79-1.88; aHR, 1.80; 95% CI, 1.44-2.27) or complex chronic medical complexity (aOR, 1.95; 95% CI, 1.89-2.00; aHR, 1.92; 95% CI, 1.67-2.21) had higher odds and likelihood of disenrollment, with estimated disenrollment rates of 10.2% and 10.4%, respectively, compared with 6.3% among those with nonchronic medical complexity.","_key":"66b0e4c873db"}],"_type":"block","style":"normal","_key":"a7b77c5fb7cf","markDefs":[]},{"uploadAudio":null,"medias":null,"_key":"58aaf3061407","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"c4e89bc3022f"}],"_type":"block","style":"normal","upload_doc":null},{"children":[{"text":"The researchers acknowledged their study’s limitations, one being that it only included community-based health care organizations within the OCHIN network. 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The budget includes an $880 billion cut to programs that fall under the jurisdiction of the House Energy and Commerce Committee, including Medicaid.","_key":"d3e3a688687b"},{"_type":"span","marks":["sup"],"text":"1","_key":"a9124cc696af"}],"_type":"block","style":"normal","_key":"8ccab9da8525","markDefs":[]},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"034c81c2d45d","_type":"span"}],"_type":"block","style":"normal","_key":"7e7c9d1024b6"},{"_key":"ab84b7edf56a","markDefs":[],"children":[{"_type":"span","marks":[],"text":"With the new administration, several contradictory statements have been released regarding the future of Medicaid in the country. During his confirmation hearings, Robert F. Kennedy, Jr made several incorrect statements regarding how Medicaid receives funding and how high premiums and deductibles were for those using Medicaid.","_key":"902300976234"},{"_type":"span","marks":["sup"],"text":"2","_key":"b3f473c1f399"},{"_type":"span","marks":[],"text":" President Trump previously said that Medicaid funding would not be cut before endorsing the budget that would bring about hundreds of billions of dollars in cuts.","_key":"ab2d63e283e7"},{"marks":["sup"],"text":"3","_key":"e2254ddf825f","_type":"span"}],"_type":"block","style":"normal"},{"style":"normal","_key":"07c677903b67","markDefs":[],"children":[{"marks":[],"text":"","_key":"8e6e0e059a9f","_type":"span"}],"_type":"block"},{"style":"normal","_key":"2d47eb0a8294","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Should the budget pass in the House, the implications could be widespread. With federal spending halted, states would have to pick up the budget to compensate, meaning their citizens could be left without Medicaid. This would primarily affect those in rural areas and those living below the poverty line.","_key":"278550c86367"},{"_type":"span","marks":["sup"],"text":"4","_key":"f9dea4ac76d1"},{"_type":"span","marks":[],"text":" Medicaid also covers approximately 40% of children in the US, which could lead to worse outcomes in the pediatric population across the country.","_key":"ee79dd9424a0"},{"_key":"dedd9efe74d7","_type":"span","marks":["sup"],"text":"5"}],"_type":"block"},{"disableLightBox":true,"imgcaption":[{"_type":"block","style":"normal","_key":"ba121fa87cb7","markDefs":[],"children":[{"_type":"span","marks":[],"text":"The House budget could cut $880 billion from the department that oversees Medicaid. | Image credit: Tada Images - stock.adobe.com","_key":"b2499626c3a1"}]}],"_type":"figure","alt":"The House budget could cut $880 billion from the department that oversees Medicaid | Image credit: Tada Images - stock.adobe.com","_key":"82cfe874e3d0","alignment":"right","asset":{"_ref":"image-ed26226475ed09729d58659b4f69dee0505dbd2a-6000x4000-jpg","_type":"reference"},"widthP":40,"disableTextWrap":false},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"States are already responding to the potential budget cuts by seeking approval from CMS to add work requirements to coverage; previous attempts to add these requirements were blocked by a federal judge.","_key":"2e5d46ee6912"},{"text":"4","_key":"f3081572b2b8","_type":"span","marks":["sup"]},{"_type":"span","marks":[],"text":" These requirements would likely eliminate coverage for the nearly 80 million Americans across the country currently using Medicaid.","_key":"c107c121a454"}],"_type":"block","style":"normal","_key":"b762ece8581a"},{"children":[{"_type":"span","marks":[],"text":"","_key":"b4bf9818f964"}],"_type":"block","style":"normal","_key":"b92576c2cca3","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Not only will Medicaid cuts affect patients, but Medicaid also acts as a primary source of funding for hospitals, community health centers, nursing homes, and physicians. According to the Kaiser Family Foundation, 37% of Medicare spending and 32% of Medicaid spending in 2023 was for hospital care.","_key":"fd20d8d9bab8"},{"text":"6","_key":"3e2531527e35","_type":"span","marks":["sup"]},{"_type":"span","marks":[],"text":" Reducing that number for Medicaid spending could affect staffing and the services being offered at hospitals, decreasing both quality of care and health care coverage for those working in hospitals and nursing homes. With hospital closings already outpacing hospital openings, the reduction in funding could have far-reaching consequences on hospitals with low funding or in areas that serve fewer patients.","_key":"5def89cbbba4"}],"_type":"block","style":"normal","_key":"ec59e1930a04"},{"_key":"98b191fdf386","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"6789a610393a"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"text":"Although President Trump has endorsed the House budget, Senate Republicans will vote on their own budget.","_key":"ab5477587909","_type":"span","marks":[]},{"marks":["sup"],"text":"3","_key":"3e642c741f9a","_type":"span"},{"_key":"6e20953e87c8","_type":"span","marks":[],"text":" The Senate budget does not include tax cuts and instead focuses on immigration, military spending, and energy. Trump has stated that he wishes for 1 bill to pass that includes all of his policy agenda, which favors the House budget. The House plans to vote on the budget next week when lawmakers return, believing the endorsement of President Trump could give them more momentum in approving the budget quickly. Democrats plan to combat the House budget by proposing amendments that no one with an income of more than $1 million can get a tax reduction if any money is cut from Medicaid."}],"_type":"block","style":"normal","_key":"93c475dbf2cc"},{"_type":"block","style":"normal","_key":"9fdb5155bea4","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"6f013ea59723"}]},{"_key":"d9d64a87c23c","markDefs":[],"children":[{"text":"References","_key":"a807728510ea","_type":"span","marks":["strong"]}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":[],"text":"1. Leonard B, Cancryn A, King R. Trump blindsides staff, Congress with conflicting Medicaid messages. Politico. Updated February 19, 2025. Accessed February 20, 2025. https://www.politico.com/news/2025/02/19/senate-medicaid-cuts-trump-00205042","_key":"1b4692d9df43"}],"_type":"block","style":"normal","_key":"3796042ad263","markDefs":[]},{"children":[{"_type":"span","marks":[],"text":"2. Mattina C. Robert F. Kennedy Jr confirmed as HHS secretary, nearly along party lines. ","_key":"3991da28eb7e"},{"marks":["em"],"text":"AJMC","_key":"aa948dbafa7d","_type":"span"},{"_type":"span","marks":["sup"],"text":"®","_key":"d4d2c6648cc2"},{"_type":"span","marks":[],"text":". February 13, 2025. Accessed February 20, 2025. https://www.ajmc.com/view/robert-f-kennedy-jr-confirmed-as-hhs-secretary-nearly-along-party-lines","_key":"2ea7162861d1"}],"_type":"block","style":"normal","_key":"60f93d95b920","markDefs":[]},{"children":[{"text":"3. Wong S, Kapur S, Zanona M, Nobles R, Santaliz K. Senate Republicans plan budget vote, despite Trump’s endorsement of competing House version. NBC News. Updated February 19, 2025. Accessed February 20, 2025. https://www.nbcnews.com/politics/congress/trump-endorses-house-gop-budget-bill-swipe-senate-plan-rcna192791","_key":"33a77662d1c4","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"f7eaeb64f6b3","markDefs":[]},{"children":[{"text":"4. Seitz A, Demillo A, Freking K. Republicans consider cuts and work requirements for Medicaid, jeopardizing care for millions. Updated February 18, 2025. Accessed February 20, 2025. https://apnews.com/article/medicaid-cuts-work-requirements-congress-republicans-90ec1119f1d95de067c76f79eec7fa87","_key":"5d8e4c6da3bb","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"f97b6871b38d","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"5. McCormick B. Medicaid unwinding left thousands of pediatric patients uninsured. ","_key":"a7c696d9936e"},{"marks":["em"],"text":"AJMC","_key":"8cbcc795d942","_type":"span"},{"_type":"span","marks":["sup"],"text":"®","_key":"d1a09f96a1ca"},{"_type":"span","marks":[],"text":". February 7, 2025. Accessed February 20, 2025. https://www.ajmc.com/view/medicaid-unwinding-left-thousands-of-pediatric-patients-uninsured","_key":"f565f3080790"}],"_type":"block","style":"normal","_key":"dbb6ea42686b"},{"children":[{"text":"6. Levinson Z, Hulver S, Godwin J, Neuman T. Key facts about hospitals. KFF. February 19, 2025. Accessed February 20, 2025. https://www.kff.org/key-facts-about-hospitals/","_key":"ef57aa299a3c","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"1548058c35ef","markDefs":[]}],"url":"trump-endorses-budget-that-would-slash-medicaid-funding","seoTag":["Medicaid","budget","Trump"],"gptSummary":"The Trump administration's inconsistent stance on Medicaid and Medicare has led to confusion, especially after President Trump endorsed a House Republican budget proposing significant cuts to Medicaid. These cuts could have widespread implications, particularly affecting rural and low-income populations, as well as children. States are responding by seeking to add work requirements to Medicaid coverage. The cuts could also impact hospitals and healthcare providers financially. While the House budget has Trump's support, the Senate is considering a different budget, focusing on other priorities like immigration and military spending.","authorMapping":[{"firstName":"Julia","displayName":"Julia Bonavitacola","_createdAt":"2022-02-23T21:42:42Z","_updatedAt":"2024-05-20T19:27:55Z","profileImage":{"_type":"mainImage","alt":"Julia Bonavitacola","asset":{"_ref":"image-fa6d7df41e3dda6f2ed66b65f3313ff5869748c2-430x430-png","_type":"reference"}},"url":{"current":"julia-bonavitacola","_type":"slug"},"lastName":"Bonavitacola","_rev":"sgy4yN0CjmArmRDnE2Khrz","_type":"author","_id":"15b1de57-6a71-4655-ba17-eeaa1c733634","biography":[{"_type":"block","style":"normal","_key":"106fd454900b","markDefs":[{"_key":"d45285824c6f","_type":"link","href":"https://www.linkedin.com/in/julia-bonavitacola-b5aa63171/"}],"children":[{"_type":"span","marks":[],"text":"Julia is an associate editor for The American Journal of Managed Care® (AJMC®) and joined AJMC® in 2022. She produces written and video content covering multiple disease states, and assists in the screening process for manuscripts submitted to AJMC®.","_key":"8a55e07516550"}]},{"_type":"block","style":"normal","_key":"769839c11518","markDefs":[{"nofollow":true,"blank":true,"_type":"link","href":"https://www.linkedin.com/in/julia-bonavitacola-b5aa63171/","_key":"d45285824c6f"}],"children":[{"marks":[],"text":"She has a BA in English language and literature from Rutgers University. 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","gptSummary":"Managed care plans (MCPs) in California are evaluated against national benchmarks that may not account for the state's unique demographic and policy challenges. This can lead to unfair penalties and incentives. The current system's one-size-fits-all approach fails to consider regional differences, such as variations in state policies and structural network disparities. A focus on year-over-year improvement and locally tailored solutions could better address these challenges. Collaborative efforts with state regulators and a shift towards contextually relevant standards are essential for achieving equitable and meaningful healthcare outcomes.","is_visible":true,"ExcludeFromPubMedXML":false,"documentGroup":null,"_createdAt":"2025-02-18T19:42:29Z","title":"Contributor: Beyond a One-Size-Fits-All for Managed Care Plan Benchmarks","documentGroupMapping":[{"thumbnail":{"blank":true,"_type":"mainImage","link":"https://www.iehp.org/","asset":{"_ref":"image-21128a674af78d3519e35482c8883c09e1817e05-800x314-png","_type":"reference"}},"description":[{"_key":"29fab20e8d98","markDefs":[{"href":"https://www.iehp.org/","_key":"f7e20e707647","nofollow":true,"blank":true,"color":{"hsv":{"s":0.8414,"v":0.8901,"_type":"hsvaColor","h":200,"a":1},"rgb":{"a":1,"b":227,"r":46,"g":163,"_type":"rgbaColor"},"hsl":{"h":200,"l":0.5156,"a":1,"s":0.7732,"_type":"hslaColor"},"alpha":1,"_type":"color","hex":"#24a3e3"},"_type":"link"}],"children":[{"_type":"span","marks":[],"text":"With a mission to heal and inspire the human spirit, Inland Empire Health Plan (IEHP) is one of the top 10 largest Medicaid health plans and the largest not-for-profit Medicare-Medicaid plan in the country. In its 25th year, IEHP is supporting more than 1.5 million residents in Riverside and San Bernardino counties who are enrolled in Medicaid or Cal MediConnect Plans and has a growing network of over 7,800 providers and nearly 2,500 Team Members. Through dynamic partnerships with Providers and Community Organizations, paired with award-winning service and a tradition of quality care, IEHP is fully committed to their vision: We will not rest until our communities enjoy optimal care and vibrant health. 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But the current evaluation system is based on inequitable benchmarks and policies that could put the most vulnerable among us at risk.","_key":"1056a6b68b49"}],"_type":"block","style":"normal","_key":"f510e700f0d2","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Think of plans as students in a class who are all taking the same test. The underperforming students would have their pencils, iPads, and computers taken away, yet are asked to outperform the other students the following year.","_key":"7db93f97a5aa"}],"_type":"block","style":"normal","_key":"04b29c038e0c"},{"children":[{"_type":"span","marks":[],"text":"When it comes to health care quality, the stakes are high, and the stakes are real.","_key":"44d47a60ad8a"}],"_type":"block","style":"normal","_key":"c861c519ce12","markDefs":[]},{"children":[{"_type":"span","marks":[],"text":"In their purest form, comparisons can be useful. They can motivate improved performance. They can guide our decision-making. They can even help us identify risks or downsides. However, when we’re comparing performance among groups with common goals but distinct challenges, we should question whether a one-size-fits-all model is the best approach.","_key":"3b76045ae5f5"}],"_type":"block","style":"normal","_key":"0b3efef55169","markDefs":[]},{"_type":"block","style":"normal","_key":"11c4644ece6d","markDefs":[],"children":[{"marks":[],"text":"California MCPs are being evaluated against national benchmark standards and policies that do not consider all the unique challenges and needs of the diverse populations and demographics within their regions. These regions require tailored solutions that national benchmark standards do not adequately recognize.","_key":"59529a7a327b","_type":"span"}]},{"children":[{"text":"Poor performance against these national standards and benchmarks are used to deliver penalties, such as fines and sanctions. Better performance against these national standards and benchmarks can lead to incentives, such as more member assignment.","_key":"5b4bed1046d4","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"a92062d1c339","markDefs":[]},{"alignment":"right","widthP":33,"disableTextWrap":false,"blank":true,"_type":"figure","alt":"Apples and oranges | Image Credit: © vivekFx - stock.adobe.com","imgcaption":[{"style":"normal","_key":"0eaec4c1cbd4","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Benchmarking should be done with as close to apples-to-apples comparisons as possible to ensure fairness in the evaluation process. | Image Credit: © vivekFx - stock.adobe.com","_key":"46abde658093"}],"_type":"block"}],"disableLightBox":true,"_key":"68ebba56df7e","asset":{"_ref":"image-01de39b3e71277c2b662177e9c1d5249f7cdadb4-1200x686-jpg","_type":"reference"}},{"markDefs":[],"children":[{"text":"The Trouble With Apples-to-Oranges Benchmarks","_key":"04410043c523","_type":"span","marks":["strong"]}],"_type":"block","style":"h3","_key":"1562d2e27bce"},{"style":"normal","_key":"2a6d4f92de6f","markDefs":[],"children":[{"_type":"span","marks":[],"text":"\nEssential in any benchmarking effort is ensuring that organizations collect valid, reliable, and useful data. Benchmarking should be done with as close to apples-to-apples comparisons as possible to ensure fairness in the evaluation process. Comparing plans with similar characteristics, such as size, geographic location, or demographics served, allows for more meaningful insights and improvement opportunities.","_key":"b0afa12dc01f"}],"_type":"block"},{"children":[{"_type":"span","marks":[],"text":"California MCPs should not be benchmarked against national quality standards and policies because the state’s health care landscape is unique in its demographic diversity, socioeconomic factors, and regulatory environments. Although these standards and policies are well intentioned, they do not take into account a few notable examples:","_key":"190be519c14d"}],"_type":"block","style":"normal","_key":"ff66503a7838","markDefs":[]},{"_key":"42df65a2adda","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"1. Variations across state policies","_key":"bcb43ffbcd99"}],"_type":"block","style":"h4"},{"style":"normal","_key":"7c13ffe5f38f","markDefs":[],"children":[{"_key":"8d26d4eb320c","_type":"span","marks":[],"text":"Although holding health plans accountable to national benchmarks helps provide visibility of performance, it cannot assess health plans fairly. One reason for this is the wide variations in state policies. For example, some states like California do not require certain vaccinations, such as the human papillomavirus vaccine, prior to entry into the seventh grade. However, other states like Rhode Island do. This difference in statewide policy could both directly and indirectly impact the willingness of a member to receive this vaccine, thus impacting performance on the national Adolescent Immunization measure."}],"_type":"block"},{"children":[{"_type":"span","marks":[],"text":"","_key":"eb6bffc46403"}],"_type":"block","style":"normal","_key":"afa70ef06895","markDefs":[]},{"_type":"block","style":"h4","_key":"98fa836e3b7b","markDefs":[],"children":[{"marks":["strong"],"text":"2. Structural network differences","_key":"18a69d81fc87","_type":"span"}]},{"markDefs":[{"nofollow":false,"blank":true,"_type":"link","href":"https://www.ajmc.com/partners/iehp","_key":"30e687e30ebd"}],"children":[{"_type":"span","marks":[],"text":"As the health care industry continues to find ways to provide better care to members, one structural component to this is the electronic health record (EHR). Some provider networks have the luxury of being on a single EHR system, whereas others ","_key":"8f40c016240c"},{"_type":"span","marks":["30e687e30ebd"],"text":"like ours","_key":"d46492fa24b7"},{"_type":"span","marks":[],"text":" have over 100 different EHRs. And while the industry pushes toward leveraging entities like a data aggregator to address this, there are clear advantages, both from a clinical and quality performance perspective, that those on a single EHR system have. Yes, it would be ideal to transition all providers in our network to a single system, but this is just not realistic.","_key":"fb5e2819f1f2"}],"_type":"block","style":"normal","_key":"4890170db623"},{"children":[{"_type":"span","marks":[],"text":"Other factors unique to California include redetermination policies, the annual process Medicaid beneficiaries must go through to renew their eligibility. This process impacted over 15 million residents during June 2023 through May 2024, and the large transient population across the state. Variation on timing of the redetermination process across states can have big impacts on quality measure populations.\n ","_key":"0f13640311e1"}],"_type":"block","style":"normal","_key":"9bb0c7d2f482","markDefs":[]},{"_type":"block","style":"h3","_key":"4c345187bac3","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"A Path Forward","_key":"964f42077e38"}]},{"_type":"block","style":"normal","_key":"0484d03e785b","markDefs":[],"children":[{"marks":[],"text":"One way to address these issues is through maintaining a focus on improvement standards. For example, by focusing on year-over-year improvement, California MCPs can address the unique health care challenges in their specific regions with more innovative, collaborative, and transformative improvement activities. This fosters genuine improvements, targeted strategies for progress, and best practices that are directly applicable and actionable. In fact, the reason local health plans were created in California was to address the unique variation of needs across our vast state.","_key":"b63306cfaf8a","_type":"span"}]},{"markDefs":[],"children":[{"marks":["strong"],"text":"Driving meaningful outcomes","_key":"616f98fbb645","_type":"span"}],"_type":"block","style":"h4","_key":"c233c514df84"},{"style":"normal","_key":"35d8ccfaf335","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Without apples-to-apples comparisons, discrepancies caused by differing contexts and conditions can result in misleading conclusions, causing plans to compete with each other and potentially skew decisions that could negatively impact member outcomes.","_key":"17e222d1d5b6"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"As we strive for equity in health care, it’s imperative that our standards for comparison and governing policies for success reflect the diverse realities of all communities. Otherwise, we risk perpetuating a cycle that undermines the very essence of quality care.","_key":"87cd15ecdc7e"}],"_type":"block","style":"normal","_key":"e15691ef60d9"},{"_type":"block","style":"normal","_key":"66981071c9b2","markDefs":[],"children":[{"_type":"span","marks":[],"text":"One of the ways we have partnered with our state regulators is through an open dialogue and discussion of looking at national quality standards and policies. Some additional considerations could be to:","_key":"f4d423415e8e"}]},{"style":"normal","_key":"0acd241e6436","listItem":"bullet","markDefs":[],"children":[{"_key":"a8f1cb300b24","_type":"span","marks":[],"text":"Further strengthen mechanisms to support locally nuanced challenges."}],"level":1,"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Enhance patient access and work to expand provider networks within managed care plans, particularly in underserved areas.","_key":"85c8a28e69df"}],"level":1,"_type":"block","style":"normal","_key":"62877089c90c","listItem":"bullet"},{"markDefs":[],"children":[{"text":"Provide more opportunities for a meaningful comparison among relevant factors to enhance patient outcomes.","_key":"77a08c3fddfc","_type":"span","marks":[]}],"level":1,"_type":"block","style":"normal","_key":"a22aa3cc03e4","listItem":"bullet"},{"_key":"fc1557392d0f","listItem":"bullet","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Develop policies in better collaboration with the MCPs to benefit the member.","_key":"23738a63b7ec"}],"level":1,"_type":"block","style":"normal"},{"style":"normal","_key":"7dbc4abb5bcf","listItem":"bullet","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Avoid relying on national or state comparisons to dictate penalties and develop them from a contextual and improvement perspective.","_key":"c22d4c125ec3"}],"level":1,"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"As MCPs prepare to “take our exams” this year, we’re reminded that no matter the outcome, our goal will always be to do what’s best for our members. 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She joined ","_key":"7de919198f04"},{"text":"AJMC","_key":"f31a60d737e2","_type":"span","marks":["em"]},{"marks":[],"text":" in 2023, where she produces written content covering multiple disease states.","_key":"df11193684f8","_type":"span"}],"_type":"block","style":"normal","_key":"936ecf4b7f0c"},{"_type":"block","style":"normal","_key":"9af540ce04de","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"5731fbb8e0ae"}]},{"markDefs":[{"href":"https://www.linkedin.com/in/brooke-mccormick-1a254b1b6/","_key":"80a1c1a9d7cd","nofollow":true,"blank":true,"_type":"link"}],"children":[{"marks":[],"text":"She has a BA in journalism from Seton Hall University. You can connect with Brooke on ","_key":"bb68b5e8ee83","_type":"span"},{"_type":"span","marks":["80a1c1a9d7cd"],"text":"LinkedIn","_key":"4bb222fe2840"},{"_type":"span","marks":[],"text":".","_key":"c87621477700"}],"_type":"block","style":"normal","_key":"98aee68dab9d"}],"_updatedAt":"2025-01-08T16:42:13Z","lastName":"McCormick","_id":"00af9d05-a2c4-4451-a6d1-0e28b08cbb65","profileImage":{"_type":"mainImage","alt":"Brooke McCormick","asset":{"_ref":"image-1fe4e81696463cdd9c1d6b62a2e47c2228d7df99-430x430-png","_type":"reference"}},"url":{"current":"brooke-mccormick","_type":"slug"}}],"_createdAt":"2025-02-19T19:56:12Z","gptSummary":"The study evaluated the impact of the COVID-19 pandemic on remission rates in patients with epithelial ovarian cancer. Despite challenges such as delayed surgeries and altered treatment protocols, remission rates remained consistent before and after the pandemic. The study involved 748 patients from Kaiser Permanente Southern California, with no significant differences in remission rates observed between pre- and post-pandemic periods. However, race and ethnicity influenced complete remission outcomes, with non-Hispanic White patients showing a higher likelihood of achieving complete remission during the pandemic. 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Ovarian cancer was no exception, as the American College of Surgeons ","_key":"b22c8bb6c54c","_type":"span"},{"_type":"span","marks":["224f5da5328d"],"text":"categorized","_key":"4fa79ce41947"},{"_type":"span","marks":[],"text":" ovarian cancer interval cytoreductive surgery as \"semi-urgent\" to minimize COVID-19 exposure and reduce surgery-related complications and hospitalizations.","_key":"bd68ae974966"},{"_type":"span","marks":["sup"],"text":"2","_key":"344f5de354be"}],"_type":"block","style":"normal","_key":"2860c3b2276f","markDefs":[{"nofollow":true,"blank":true,"_type":"link","href":"https://www.gynecologiconcology-online.net/article/S0090-8258(20)31766-2/fulltext","_key":"224f5da5328d"}]},{"_key":"e5b7f3f239c2","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"2f30949c39f0"}],"_type":"block","style":"normal"},{"children":[{"text":"To accommodate surgery delays and reduce harm in this population, national and international gynecologic oncology societies recommended preferential use of neoadjuvant chemotherapy.","_key":"770499c807b8","_type":"span","marks":[]},{"_type":"span","marks":["sup"],"text":"1","_key":"418e5f4e2d34"},{"marks":[],"text":" The pandemic may have also impacted patient outcomes through financial strain, loss of insurance, and barriers to care, such as limited transportation. ","_key":"a4b2ac97a45c","_type":"span"}],"_type":"block","style":"normal","_key":"ece065daf223","markDefs":[]},{"_key":"b514239c46b6","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"54d0caccee57"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"marks":[],"text":"Consequently, the researchers assessed the association between the COVID-19 pandemic and cancer remission after initial treatment in patients newly diagnosed with epithelial ovarian cancer to determine whether remission rates remained consistent amid these challenges.","_key":"ee9925d93132","_type":"span"}],"_type":"block","style":"normal","_key":"1f08b932b452"},{"_type":"figure","_key":"a88b9fa4afdd","disableTextWrap":false,"alignment":"right","asset":{"_ref":"image-b494e9799158e243f77a0a93a8c86b5ea820d210-6908x3933-jpg","_type":"reference"},"imgcaption":[{"children":[{"_type":"span","marks":[],"text":"The comparable rates of remission pre- and post-pandemic suggest that COVID-19 did not negatively impact the outcomes of patients with ovarian cancer. | Image Credit: James Thew - stock.adobe.com","_key":"b1675695283a"}],"_type":"block","style":"normal","_key":"85c36e26b4fb","markDefs":[]}],"alt":"COVID-19 pandemic illustration | Image Credit: James Thew - stock.adobe.com","widthP":40,"disableLightBox":true},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Eligible patients were diagnosed with epithelial ovarian cancer between January 1, 2017, and June 30, 2021, at Kaiser Permanente Southern California, which serves a racially, ethnically, and socioeconomically diverse population. They were also required to complete chemotherapy and/or surgery as first-line treatment.","_key":"6460b5df387b"}],"_type":"block","style":"normal","_key":"a9106b7bb43b"},{"children":[{"text":"","_key":"1c9f1d7a9a0f","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"a1c58cae1ea2","markDefs":[]},{"_type":"block","style":"normal","_key":"367c82d67618","markDefs":[],"children":[{"text":"The researchers designated pre- and post-pandemic periods using March 4, 2020, as the cut-off; this was when California implemented the stay-at-home order. Additionally, they collected data on complete and clinical remission outcomes by manual chart reviews. Complete remission was considered no evidence of disease; clinical remission included both complete remission and partial response, defined as an incomplete or partial response to therapy.","_key":"0b7235781e80","_type":"span","marks":[]}]},{"_key":"1dc33447ddcc","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"14579ad65616"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"text":"Modified Poisson regression was used to evaluate the association between remission and the COVID-19 pandemic. The researchers also assessed effect modification by race and ethnicity.","_key":"036e6d14cd16","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"519f027a496f"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"e29079a44ced"}],"_type":"block","style":"normal","_key":"4e85ffbc506b"},{"markDefs":[],"children":[{"marks":[],"text":"The study population consisted of 748 patients with ovarian cancer, 72.7% of whom were diagnosed during the pre-pandemic period and 27.3% during the pandemic. The researchers found that patients diagnosed during the pandemic were slightly younger than those diagnosed in the pre-pandemic period (mean age, 60.9 vs 62.6 years; ","_key":"d90f86403143","_type":"span"},{"text":"P ","_key":"6f849d93aecd","_type":"span","marks":["em"]},{"_key":"51cdfb16f2e0","_type":"span","marks":[],"text":"= .11)."}],"_type":"block","style":"normal","_key":"095f66d6a8a6"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"59a6947336b1"}],"_type":"block","style":"normal","_key":"3a0039ae2438"},{"_type":"block","style":"normal","_key":"cb6a22722a8f","markDefs":[],"children":[{"_type":"span","marks":[],"text":"As for race and ethnicity, 46.8% of patients were non-Hispanic White, 33.0% Hispanic, 12.4% Asian/Pacific Islander/other races, and 7.5% non-Hispanic Black patients. In terms of disease stage, as defined by the International Federation of Gynecology and Obstetrics (FIGO), stage III was the most common at diagnosis (39.6%), followed by stage I (27.8%), stage IV (21.5%), and stage II (11.1%). However, no statistically significant differences in race/ethnicity (","_key":"983d8ed5df49"},{"_type":"span","marks":["em"],"text":"P ","_key":"945ac7b3f746"},{"_type":"span","marks":[],"text":"= .09) or FIGO stage (","_key":"3953f2258de3"},{"_key":"f85fff790750","_type":"span","marks":["em"],"text":"P "},{"text":"= .65) were observed before or during the pandemic.","_key":"4407673361e1","_type":"span","marks":[]}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"ce5f62fa84b3"}],"_type":"block","style":"normal","_key":"200338e7e98b"},{"children":[{"text":"After initial therapy completion, 87.2% of patients achieved clinical remission, and 75.1% achieved complete remission. Conversely, 12.8% did not respond to treatment. The researchers determined that the proportion of patients achieving complete remission before and during the pandemic was 75.7% and 73.5%, respectively (","_key":"2f65e1a272f4","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"P ","_key":"b8fecee16fa0"},{"_type":"span","marks":[],"text":"= .53).","_key":"e14ea8d82ea0"}],"_type":"block","style":"normal","_key":"dd47ea0f3b15","markDefs":[]},{"_type":"block","style":"normal","_key":"c1e4d6a48ea0","markDefs":[],"children":[{"_key":"57b10dca9589","_type":"span","marks":[],"text":""}]},{"_type":"block","style":"normal","_key":"7b095a0a8d17","markDefs":[],"children":[{"_type":"span","marks":[],"text":"The pandemic period was not associated with complete remission in the bivariate (risk ratio [RR], 0.97; 95% CI, 0.88-1.07) or multivariate (adjusted RR, 0.98; 95% CI, 0.90-1.06) models. Similarly, the pandemic period was not associated with clinical remission in either the bivariate (RR, 0.98; 95% CI, 0.92-1.04) or multivariate (adjusted RR, 0.98; 95% CI, 0.92-1.04) models.","_key":"2441edcd3de7"}]},{"style":"normal","_key":"5babce5b3aa1","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"0f2a2d8cd45b"}],"_type":"block"},{"style":"normal","_key":"aafbbdf1d695","markDefs":[],"children":[{"_type":"span","marks":[],"text":"However, race and ethnicity modified the association between the pandemic period and complete remission (","_key":"ac3b99afbb2f"},{"text":"P ","_key":"8e0e133d7de1","_type":"span","marks":["em"]},{"_type":"span","marks":[],"text":"\u003c .01). After adjusting for various factors, non-Hispanic White patients were 13% more likely to achieve complete remission during the pandemic than in the pre-pandemic period (RR, 1.13; 95% CI, 1.00-1.28). In contrast, race/ethnicity did not influence the association between the pandemic and clinical remission (","_key":"c5810d9f40bd"},{"_type":"span","marks":["em"],"text":"P ","_key":"49631294e06e"},{"_type":"span","marks":[],"text":"= .90).","_key":"f89426ecb43a"}],"_type":"block"},{"style":"normal","_key":"e0edfd4c41e5","markDefs":[],"children":[{"_key":"fc60e997268d","_type":"span","marks":[],"text":""}],"_type":"block"},{"_type":"block","style":"normal","_key":"7494ee9854d2","markDefs":[],"children":[{"_key":"9bee276985e3","_type":"span","marks":[],"text":"The researchers acknowledged their study’s limitations, including that the cohort consisted of insured patients within an integrated health care system. Therefore, their findings may not be generalizable to uninsured patients or those within other types of health care systems. Despite its limitations, the researchers expressed confidence in their study."}]},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"60678675f63c","_type":"span"}],"_type":"block","style":"normal","_key":"1d414c0296aa"},{"_key":"17b596fa1a85","markDefs":[],"children":[{"marks":[],"text":"“Comparable rates of complete and clinical remission before and after the onset of the pandemic offer some reassurance that outcomes of patients with ovarian cancer were not negatively impacted during the pandemic in our integrated health care system,” the authors concluded.","_key":"336333341ff3","_type":"span"}],"_type":"block","style":"normal"},{"_key":"c0bde55b3020","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"061c2069133a"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"fa0aa2eaa885","markDefs":[],"children":[{"marks":["strong"],"text":"References","_key":"d8172850561c","_type":"span"}]},{"_key":"42f35071c27e","listItem":"number","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Mukherjee A, Ayoub N, Xu L, et al. Clinical remission rates in patients with epithelial ovarian cancer before and after the onset of the COVID 19 pandemic in an integrated healthcare delivery system. ","_key":"b166f5163b61"},{"_key":"e5e345ee8d23","_type":"span","marks":["em"],"text":"Cancer Manag Res"},{"_type":"span","marks":[],"text":". 2025;17:281-291. doi:10.2147/CMAR.S487894","_key":"97a039e381f5"}],"level":1,"_type":"block","style":"normal"},{"level":1,"_type":"block","style":"normal","_key":"0cbca8201fbc","listItem":"number","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Fader AN, Huh WK, Kesterson J, et al. When to operate, hesitate and reintegrate: Society of gynecologic oncology surgical considerations during the COVID-19 pandemic. 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Data used for the report were the most recent available in the databases.","_key":"7f1eafa2e494","_type":"span"}],"_type":"block","style":"normal","_key":"b3ba0322ce9a"},{"_key":"60994c6bde8f","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"9d5cbe7429a3"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"43299e24caf1","markDefs":[],"children":[{"text":"The authors found that there will be an estimated 248,470 diagnoses and 73,240 deaths related to cancer in Black individuals, accounting for the second leading cause of death in Black individuals in 2025. Overall, the mortality rate associated with cancer declined from 49% in 1991 to 33% in 2022. Black men experienced the highest decline in mortality related to cancer compared with Black women, White men, and White women, with a 65% to 67% drop among Black men aged 40 to 59 years.","_key":"a93b85323095","_type":"span","marks":[]}]},{"alignment":"left","disableTextWrap":false,"disableLightBox":true,"alt":"Black individuals had worse mortality outcomes related to cancer compared with other population groups | Image credit: Monkey Business - stock.adobe.com","asset":{"_ref":"image-4b1e70c0107d954ccd83281363addeca769a16bd-4992x3328-jpg","_type":"reference"},"_type":"figure","_key":"4009f2e78ad8","imgcaption":[{"markDefs":[],"children":[{"text":"Black individuals had worse mortality outcomes related to cancer compared with other population groups | Image credit: Monkey Business - stock.adobe.com","_key":"b098725d2b27","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"ab0328b11fe5"}],"widthP":40},{"children":[{"_type":"span","marks":[],"text":"However, the risk of cancer death was still high among Black individuals. Myeloma, prostate, endometrial, and stomach cancers had a risk of cancer death in Black individuals that was 2-fold higher compared with White individuals. Colorectal, breast, cervical, and liver cancers all had a 40% to 50% higher risk of death in Black individuals.","_key":"455b35dce1c8"}],"_type":"block","style":"normal","_key":"3adad0b4f574","markDefs":[]},{"children":[{"_type":"span","marks":[],"text":"","_key":"1a154bbb2875"}],"_type":"block","style":"normal","_key":"e23cba8e1bc7","markDefs":[]},{"_type":"block","style":"normal","_key":"e6951ccec4c8","markDefs":[],"children":[{"_key":"bebeef0bca7d","_type":"span","marks":[],"text":"The most reported cancers diagnosed in Black individuals were prostate (44% in men), breast (34% in women), lung (10%), and colorectal (8%) cancers . These cancers also made up 58% of all new diagnoses. The likelihood of dying from breast cancer was 38% higher in Black women compared with White women, while the likelihood of being diagnosed with breast cancer was 5% lower in Black women. The incidence rate of prostate cancer was also 67% higher in Black men compared with White men, with Black men twice as likely to die. The incidence of endometrial cancer also increased in Black women by 2% each year."}]},{"_type":"block","style":"normal","_key":"9178d7061d91","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"d5a692eae008"}]},{"_type":"block","style":"normal","_key":"33262444679c","markDefs":[],"children":[{"_type":"span","marks":[],"text":"“Overall declines in cancer mortality rates in Black people largely reflect behavioral changes, such as historical declines in cigarette smoking among Black teens, as well as advances in treatment and earlier detection for some cancers. Yet, this population persistently experiences a much higher mortality burden than other racial and ethnic groups for many cancers. We must reverse course,” said Rebecca Siegel, MPH, senior scientific director, surveillance research at the American Cancer Society and senior author of the report, in a statement.","_key":"b8a7ee2c1cae"},{"_type":"span","marks":["sup"],"text":"1","_key":"a927d15f0885"}]},{"markDefs":[],"children":[{"text":"","_key":"bfa9350df402","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"c3dcc9c991b4"},{"_type":"block","style":"normal","_key":"e308c401b4a6","markDefs":[],"children":[{"_type":"span","marks":[],"text":"These results are in line with past research that has found a continuing disparity in both diagnoses and health care related to health care in Black individuals. Researchers have found that Black women are less likely to receive care according to guidelines when compared with White women and an increased mortality in Black women due to these care disparities.","_key":"8b51ee392c64"},{"marks":["sup"],"text":"2","_key":"05cd6bb5cfc0","_type":"span"},{"_type":"span","marks":[],"text":" Racial discrimination has also been a source of disparities in outcomes among Black individuals, with most participants of a study published by the ","_key":"31cae70ee917"},{"_type":"span","marks":["em"],"text":"Journal of the National Cancer Institute","_key":"ffba9c63da83"},{"marks":[],"text":" reporting that they had experienced racial discrimination when accessing health care related to cancer.","_key":"cd5b5ba4284a","_type":"span"},{"_type":"span","marks":["sup"],"text":"3","_key":"e7ea32dacbc8"}]},{"_key":"d7797d9c7449","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"189fe2053753"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"text":"\"This report highlights the disparities the Black community has faced for decades. While the decline in cancer mortality rates is encouraging, the stark inequities in incidence and survival for many cancers underscore the urgent need for targeted research and interventions,” said Dr. Wayne A. I. 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News release. American Cancer Society. ","_key":"c7be583058e3","_type":"span"},{"_type":"span","marks":["141f46f02109"],"text":"https://www.newswise.com/articles/new-acs-study-shows-cancer-mortality-rates-among-black-people-declining-but-remain-higher-than-other-racial-and-ethnic-groups/","_key":"bb868b156fe8"}],"level":1,"_type":"block","style":"normal"},{"style":"normal","_key":"293313a074d6","listItem":"number","markDefs":[{"_type":"link","href":"https://www.ajmc.com/view/racial-inequities-in-guideline-adherent-breast-cancer-care-and-timely-treatment","_key":"4c24796bbf4b","nofollow":false,"blank":true}],"children":[{"_type":"span","marks":[],"text":"Santoro C. Racial inequities in guideline-adherent breast cancer care and timely treatment. ","_key":"65f12faae767"},{"text":"AJMC","_key":"3bda46bc48a0","_type":"span","marks":["em"]},{"text":"®","_key":"809bd700ed77","_type":"span","marks":["sup"]},{"_type":"span","marks":[],"text":". November 19, 2024. Accessed February 19, 2025. 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The American Cancer Society's report highlights significant disparities in cancer incidence and outcomes, with Black men experiencing the highest decline in mortality. However, Black individuals remain at a higher risk for certain cancers, such as myeloma and prostate cancer. 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