Fourteen states received failing grades, while an additional 13 received D’s in LUNGevity’s Lung Cancer Scorecard, a report that assigned states a “lung cancer performance score” based on five specific factors that analyzed a state’s performance in addressing lung cancer.
The 5 points of analysis included coverage for lung cancer screening, coverage for comprehensive biomarker testing, Medicaid expansion, lung cancer incidence, and lung cancer survival.
The LUNGevity Foundation, which aims to accelerate research to patients, empower them to actively participate in treatment decisions, and remove barriers they face accessing the right treatments, used the report to identify “areas that are in need of improvement, as well as proposed solutions that states may adopt.”
“We have a focus at LUNGevity of really ensuring that all people diagnosed with lung cancer have access to optimal care,” said Andrea Ferris, CEO of LUNGevity Foundation. “This scorecard was our way of really going through state by state to identify policies that really could affect the most vulnerable populations—being those on Medicaid—to ensure that they too had access to optimal care.”
Analysis of the coverage for lung cancer screening showed a third of states do not cover lung cancer screening as a part of the Medicaid Fee-for-Service program. Next was coverage for comprehensive biomarker testing, which was covered by just under 40% of states.
As for Medicaid expansion, 14 states had not expanded coverage as of January 2020. Even more, the report concluded that a lack of Medicaid expansion correlated with less favorable coverage policy and poor cancer outcomes.
The final two factors were analyzed on an above or below average scale, with 27 states grading above the national lung cancer incidence rate, while 33 states (and Washington DC) graded at or below the national average for 5-year survival rate.
This raw data from the report regarding the five key factors ultimately helped the researchers draw the following conclusions and suggestions for states moving forward:
1. State cancer plans show the understanding of lung cancer as a public health priority
2. Coverage for lung cancer screening can and should be improved
3. Coverage for comprehensive biomarker testing must improve or Medicaid patients risk an inferior outcome
4. States must recognize the importance of cancer clinical trials in improving care by removing impediments to patient participation and enacting aggressive policies promoting trial participation
5. An ongoing dialogue with state Medicaid agencies has the potential to yield substantial population benefits with only modest changes to Medicaid lung cancer coverage policy and modest associated costs
Ferris and Senior Vice President of Marketing and Communications, Linda Wenger, emphasized that these policy recommendations are sensible changes that wouldn’t cost states billions of dollars to enact. These are adjustments to ensure the advances made in the lung cancer field “don't just benefit those that can afford it.”
Of the 50 states and Washington DC that were reported on, only 12 scored a B or higher. Of those 12, only Maryland, Minnesota, Oregon and Washington scored an A, according to the report. The report signals a need for most of the states to re-examine their policies on lung cancer to better address the growing issues.
“It’s on us and on other advocates as well to start working at the state level to modify the policies,” said Ferris. “And I think that the report card gives us that roadmap of where to go.”
LUNGevity Foundation. State Scorecard: State Medicaid Coverage Policy. LUNGevity website. https://lungevity.org/sites/default/files/state-scorecards/Lungevity-Scorecard_v9.pdf. Published February 2020. Accessed February 21, 2020.