A look at ACCESS

By Sonja Likumahuwa-Ackman

On April 1, OHSU Family Medicine’s research team, led by Jennifer DeVoe, M.D., D.Phil., began working on a five-year, $2.5 million project called ACCESS (Assessing Community Cancer care after insurance ExpanSionS). Funded by the National Cancer Institute, ACCESS is the newest of a set of grant projects studying the effects of the Medicaid Expansion under the Affordable Care Act. This new grant will look specifically at cancer prevention and primary care for cancer survivors in 700 different community health centers (CHCs) across 21 states.

The large number and diversity of the CHCs will allow OHSU Family Medicine to compare what happens to health center patients in states that chose to expand Medicaid, and those that did not. Researchers will be able to see whether or not health center patients received appropriate cancer screenings, if there were big differences in the quality of care for cancer survivors across the clinics, and whether or not some patients had better access to health insurance and healthcare than others.

Additionally, in looking only at the states that elected to expand Medicaid services to patients, the team will be able to see what happens when patients gained Medicaid through the expansion. The team will compare three patient groups: Those who had Medicaid and kept it, those who were uninsured and remained uninsured, and those who were uninsured and gained Medicaid through the expansion.

The third group will be especially enlightening, as they will show the research team what impact Medicaid had on the patients’ care. OHSU Family Medicine’s team will look at how these newly insured patients accessed primary care, what types of care they used, and if they experienced a difference in cancer prevention, cancer screening, and cancer survivor care.

There is currently a wealth of research information regarding cancer treatment, screenings, diagnosis, and prevention. Disparities in cancer, however, such as higher death rates, less frequent use of screenings, and higher rates of diagnoses, are relatively unstudied. Over the next five years, OHSU Family Medicine will help change that, ensuring a better understanding of how we can help all of our community members fulfill their cancer care needs.