{"id":275359,"date":"2022-10-28T05:30:00","date_gmt":"2022-10-28T12:30:00","guid":{"rendered":"https:\/\/calmatters.org\/?p=275359"},"modified":"2022-10-27T17:39:51","modified_gmt":"2022-10-28T00:39:51","slug":"atencion-del-cancer-en-california","status":"publish","type":"post","link":"https:\/\/calmatters.org\/_es\/health\/2022\/10\/california-cancer-care\/","title":{"rendered":"La atenci\u00f3n del c\u00e1ncer en California no es equitativa; una nueva ley podr\u00eda ayudar"},"content":{"rendered":"\t\t\n\t\t
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In summary<\/strong><\/p>\n\t\t\t\t\n\n\t\t\t\t\n\t\t\t\t

Low-income patients who need specialized cancer treatment often struggle to get it. Advocates say a new law is a small step toward improving services for those patients. <\/p>\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\n\t\t\n

Cancer is the second leading cause of death in California, behind only heart disease. This year alone, the state will tally an estimated 189,000 new cancer cases<\/a> and close to 61,000 deaths.<\/p>\n\n\n\n

Yet while patients often need specialists, treatments and the chance to participate in clinical trials, that access is not equitable throughout the state. It typically depends on where they live, and sometimes on their health insurance. <\/p>\n\n\n\n

Lower-income cancer patients \u2014 and especially those in rural places \u2014  tend to fare worse<\/a>. Studies have shown<\/a> that patients with Medi-Cal, the health insurance program for low-income residents, are less likely to get the recommended treatment and have lower cancer survival rates compared to people with private insurance. <\/p>\n\n\n\n

This disparity is at the crux of a California bill recently signed into law by Gov. Gavin Newsom that supporters say will make it at least a little easier for Medi-Cal patients to access cancer subspecialists, treatments and clinical trials. <\/p>\n\n\n\n

The new law<\/a>, which goes into effect in January, requires Medi-Cal insurance plans to \u201cmake a good faith effort\u201d to contract with cancer centers recognized by the National Cancer Institute<\/a> \u2014 which often have access to the latest treatments \u2014 or other qualifying cancer centers.<\/p>\n\n\n\n

Authored by Democratic Sen. Anthony Portantino<\/a> of Glendale, it was originally drafted to mandate that Medi-Cal plans add at least one of these cancer centers to their provider networks, but negotiations resulted in a scaled-back version, only requiring health plans to try to add a cancer center. <\/p>\n\n\n\n

\u201cI think making incremental change has the ability to save lives and that\u2019s what we\u2019re trying to do here.”<\/p>state sen. anthony portantino, democrat from glendale<\/cite><\/blockquote><\/figure>\n\n\n\n

The law also requires Medi-Cal plans to notify enrollees with complex cancers about their right to request a referral to any of these centers, even if it’s out of their plan\u2019s network. Whether a patient can be treated at one of these centers, however, depends on whether the plan and the out-of-network provider can hash out a payment deal. This referral notification, supporters say, is critical: Patients can\u2019t ask for something they don\u2019t know is an option. <\/p>\n\n\n\n

Supporters say that even if limited, this  law will be an important step in helping low-income cancer patients get specialized care. <\/p>\n\n\n\n

\u201cI think making incremental change has the ability to save lives and that\u2019s what we\u2019re trying to do here,\u201d Portantino said. <\/p>\n\n\n\n\n\n

Too often patients from underserved communities arrive at these specialized cancer centers very late after their diagnosis, said Dr. Joseph Alvarnas, a hematologist-oncologist and vice president of government affairs at City of Hope<\/a>, one of eight California cancer centers with a National Cancer Institute designation, and a sponsor of the law. <\/p>\n\n\n\n

\u201cThe conversation begins with \u2018If I could only have gotten here sooner\u2019, or \u2018My family and I fought tooth and nail to get here,\u2019\u201d he said. <\/p>\n\n\n\n

Alvarnas said that historically, City of Hope used to see more Medi-Cal patients, but that changed as the state has largely moved its Medi-Cal program from a fee-for-service model (in which patients could see any provider who accepted Medi-Cal and the state paid providers for each service rendered) to managed care (considered a more cost-effective model in which the state pays health insurance companies a fixed amount per enrollee).  <\/p>\n\n\n\n

\u201cIn managed care, part of the way that model works is it includes narrower clinician networks and more limited hospital choices,\u201d Alvarnas said. \u201cIf you have high blood pressure or you’ve got a condition that can be cared for by many types of doctors, that’s an OK model.<\/p>\n\n\n\n

\u201cBut when it comes to cancer care, your network of clinicians may not have an expert in leukemia or relapsed myeloma.\u201d<\/p>\n\n\n\n

Hospitals sometimes must send some of their sickest patients to cancer centers like City of Hope \u2013 as was the case for Patrick Nandy of Whittier. In 2008, during his senior year of college, he was diagnosed with acute lymphoblastic leukemia, a cancer of the blood and bone marrow that can progress very quickly. Nandy said that when oncologists at St. Jude Medical Center could no longer treat him, he was transferred to City of Hope, where he participated in a chemotherapy clinical trial and a cord blood stem cell transplant. <\/p>\n\n\n\n

\u201cI think about how lucky I am,\u201d Nandy said. \u201cDoctors said two more weeks and I probably would have been gone.\u201d<\/p>\n\n\n\n

These are the types of therapies that should be available to all patients with complex or aggressive cancers, but that\u2019s not always the case, Alvarnas said. <\/p>\n\n\n\n

A 2015 analysis by the University of California, Davis<\/a>, found worse outcomes for cancer patients with Medi-Cal compared to people with other types of insurance. Among some of the findings: 39% of breast cancer patients on Medi-Cal were diagnosed at an early stage compared to 61% of those who were privately insured. <\/p>\n\n\n\n

The study also found Medi-Cal patients diagnosed with early stage lung cancer had a 48% five-year survival rate, lower than the 65% five-year survival rate for those with private insurance. Medi-Cal patients also were less likely to receive the necessary therapies or treatments for several cancer types. <\/p>\n\n\n\n\u200b\u200b

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