Understanding the impact of insurance coverage across the cancer care continuum: Moving beyond fragmented systems and cross-sectional data to inform policy

Jennifer Tsui, Lindsay M. Sabik, Joel C. Cantor

Publication Date: 04/27/2020

Understanding the impact of health insurance coverage on access to and quality of cancer care, as well as the implications for cancer outcomes, is critically important for informing practice and policy within the complex and changing health-care context. In this issue of the Journal, Yabroff et al. (1) conducted a systematic review of 29 studies, published between 1980 and 2019, evaluating health insurance coverage disruptions and cancer care and outcomes in the United States. They found coverage disruptions strikingly common across studies and associated with lower quality of care and poorer outcomes. This thorough synthesis of the literature is an important step toward understanding the role of continuity of health insurance coverage and points to the immense heterogeneity across studies, including variation in cancer sites studied, definitions of insurance disruptions, and periods of interest across the cancer care continuum. Their important review suggests a number of opportunities for improving measurement of continuity of coverage to inform improvements in cancer care delivery and quality…