Medicare Insurance Type and Broad Genomic Profiling in Metastatic Cancer

Is the use of broad genomic profiling (BGP) associated with Medicare payer type or hospital referral region (HRR) among Medicare beneficiaries with metastatic cancer?In this nationwide cohort study of 254 720 Medicare beneficiaries with newly diagnosed metastatic cancer, BGP use was significantly higher among fee-for-service Medicare than Medicare Advantage enrollees, including for cancers with explicit guideline recommendations for BGP. BGP use also varied markedly across HRRs.Findings suggest that BGP use differed by Medicare payer type and showed substantial regional variation, underscoring the need for policies that support guideline-concordant molecular testing for patients with metastatic cancer.

Corresponding Author: Cary P. Gross, MD, Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, 333 Cedar St, PO Box 208056, New Haven, CT 06520 (cary.gross@yale.edu).

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