Improving Access to Biomarker Testing in Medicaid Populations

Precision medicine and comprehensive genomic profiling are redefining cancer care and clinical outcomes, yet disparities in access to guideline-concordant care persist for patients with lower socioeconomic status, lower health literacy, who live in rural or underserved areas, or who belong to traditionally underserved populations (eg, racial or ethnic minorities or patients impacted by social determinants of health). Medicaid beneficiaries, who represent approximately 15% of patients with cancer under the age of 64 and who are often impacted by one or more social determinants, are thus more likely to face disparities in access to comprehensive cancer care.

In 2022, the Association of Community Cancer Centers and the LUNGevity Foundation conducted a study to explore the barriers to equitable biomarker testing in patients with non-small cell lung cancer. Findings revealed that despite the likelihood of oncology providers to discuss and order guideline-concordant biomarker testing during a patient’s disease trajectory, decreases in biomarker testing were observed in patients of lower socioeconomic status and those perceived to have low health literacy. In another study of 7,000 patients with non-small cell lung cancer, Medicaid beneficiaries were 19% less likely to undergo biomarker testing compared with commercially-insured patients and had a 27% higher risk of mortality compared to those who received testing.

To raise awareness among providers, patients, and health plans about the importance of increasing access to comprehensive genomic profiling and quality cancer care, the Association of Community Cancer Centers (ACCC) has partnered with the American Cancer Society Cancer Action Network (ACS CAN) and LUNGevity on an educational initiative to identify and address existing disparities in access to biomarker testing among Medicaid beneficiaries. Through a series of focus groups and insights from multidisciplinary stakeholders, this program explores current Medicaid coverage rules related to biomarker testing across the country, patient and provider perspectives on disparities in access to testing among Medicaid recipients, and the value of comprehensive genomic profiling and biomarker testing in personalizing cancer care.

Findings from this program will help guide development of future initiatives and resources cancer programs can utilize to address current barriers to biomarker testing and to optimize care delivery for Medicaid beneficiaries.

To get involved with this work, please contact the Provider Education department.