When someone is diagnosed with cancer, getting the right doctor quickly can make a big difference. But for the 1 in 5 people in the United States reliant on Medicaid, finding a cancer specialist isn’t easy. Not all oncologists accept Medicaid, often because Medicaid pays less than other insurance plans. That can lead to delays in care — and delays can mean worse outcomes.
People on Medicaid are more likely to be diagnosed with cancer at a later stage and are less likely to survive compared to others. A big reason why? Trouble accessing timely, high-quality care.
The Problem: Unclear Provider Networks
It is often difficult to figure out which cancer care providers accept Medicaid, since Medicaid is not one thing. Each state has different rules for Medicaid and within states there are different types of Medicaid, such as managed care and fee-for-service plans. Most data about provider networks comes from doctors reporting whether they accept Medicaid—but that information isn’t always accurate. A doctor might think they accept Medicaid, but their hospital or clinic may not accept all types of Medicaid plans.
The Solution: A Data-Driven Approach
To get a clearer picture, Milken Institute School of Public Health Professor Anushree Vichare and her team took a different approach. Instead of relying on self-reports, they combined multiple large national data sources from 2016–2020, including:
- Doctor certification records
- Medicaid enrollment data
- Real billing and claims data
By linking all of this information, they could see which oncologists were actually treating patients with Medicaid—and what kinds of patients they were seeing.
What Did They Find?
- Most oncologists (about 85–89%) did treat Medicaid patients, which is encouraging.
- But participation declined slightly over time, even as more Medicaid patients needed care.
- Many doctors treated a wide range of cancers, while a smaller group focused mostly on specific types, like breast cancer.
- Very few oncologists—only 5%--worked in rural areas, where access is already limited. This means that people who live in rural areas who are diagnosed with cancer have long travel times and fewer options—which directly impacts survival outcomes.
Why Does This Matter?
This study gives us the clearest picture yet of the cancer care workforce for Medicaid patients.
Why is that important?
Because you can’t fix a problem if you don’t know where the gaps are.
With better data, policymakers and health leaders can:
- Identify areas with too few cancer doctors
- Track whether access is improving or getting worse
- Make smarter decisions about funding and policy
This study maps out where cancer care is strong and where it’s falling short, so we can work toward a system where everyone gets the care they need, when they need it.
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A case in point: Washington, DC In 2010, it was unclear why patients with Medicaid diagnosed with cancer in Washington, DC were sent to one hospital for surgery, another for radiation, and another for chemotherapy. From 2014-2016, a team from the GW Cancer Center worked with the Washington, DC Department of Health Care Finance to review claims that came to Medicaid and better understand who had access to cancer care. They found that most chemotherapy was reimbursed by Medicaid plans for less than the cost of obtaining the drug unless a practice was associated with a drug discount program called 340B. After identifying the problem, the DC Department of Health Care Finance submitted what is called a State Plan Amendment to the Centers for Medicaid and Medicare Services (CMS) asking for chemotherapy and supportive care medications to be reimbursed at the same rates as Medicare. This expanded the oncology network in Washington, DC. Vichare et al.’s study makes it easier for people to understand who has access to cancer care, so that such time intensive case-by-case analyses are less likely to be needed in the future. |
What’s next?
Vichare and her team studied data from 2016 to 2020, but it’s important to keep tracking what’s happening now and in the future. A challenge is that national health data is often delayed. That’s because it takes time to approve the data, process insurance claims, check for mistakes, and remove personal details to protect patient privacy.
Policy changes can make things even more complicated. For example, a new law passed in 2025 requires many people on Medicaid to work and to regularly prove they still qualify for coverage.
According to The American Society of Clinical Oncology, cancer patients often face serious side effects and a higher risk of infection, which can make working difficult or even impossible. On top of that, cancer care already involves a lot of paperwork and coordination. Asking patients to apply for exemptions from work requirements can add even more stress during an already overwhelming time.
These new rules could also lead to more people losing their insurance—even temporarily. That’s especially concerning for patients diagnosed with cancer at later stages, who need fast, consistent treatment.
