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Medicare participants with a cancer diagnosis are less likely to switch from a managed care plan to traditional fee-for-service Medicare than matched subjects who do not have a cancer diagnosis, a study shows.

Medicare participants with a cancer diagnosis are less likely to switch from a managed care plan to traditional fee-for-service Medicare than matched subjects who do not have a cancer diagnosis, a study in the Journal of the National Cancer Institute shows.

In many locations, Medicare beneficiaries can choose between traditional fee-for-service insurance and managed care plans. Managed care plan participants incur fewer out-of-pocket costs than those enrolled in traditional Medicare but may be restricted in their access to particular healthcare providers.

To determine whether Medicare participants are likely to disenroll from managed care plans following a cancer diagnosis, Elena Elkin, Ph.D., of Memorial Sloan-Kettering Cancer Center in New York and colleagues used the Surveillance, Epidemiology, and End Results (SEER) database and linked Medicare enrollment files. The researchers identified 28,331 women with breast cancer, 26,494 individuals with colorectal cancer, 29,046 men with prostate cancer, and 31,243 individuals with lung cancer who were diagnosed between 1995 and 2002. The researchers compared the frequency of voluntary disenrollment during the two years after diagnosis with enrollment changes by matched control subjects who did not have a cancer diagnosis.

Cancer patients were statistically significantly less likely to disenroll from a Medicare managed care plan than individuals who were cancer-free. The results were consistent across age, disease site and stage, race, and location in the United States.

"If voluntary disenrollment from Medicare managed care is, in fact, beneficiaries' way of 'voting with their feet,' then our results suggest that enrollees facing a serious, potentially life-threatening illness are as satisfied with Medicare managed care, if not more so, than their cancer-free peers," the authors write.