Cancer Causes & Control

, Volume 30, Issue 10, pp 1137–1144 | Cite as

Care experiences among dually enrolled older adults with cancer: SEER-CAHPS, 2005–2013

  • Lisa M. LinesEmail author
  • Julia Cohen
  • Michael T. Halpern
  • Ashley Wilder Smith
  • Erin E. Kent
Original Paper



Given the associations between poverty and poorer outcomes among older adults with cancer, we sought to understand the effects of dual enrollment in Medicare and Medicaid—as a marker of poverty—on self-reported care experiences among seniors diagnosed with cancer.


Retrospective, observational study using cancer registry, Medicare claims, and care experience survey data (Surveillance, Epidemiology, and End Results [SEER]—Consumer Assessment of Healthcare Providers and Systems [CAHPS®]) for a national sample of fee-for-service (FFS) and Medicare Advantage (MA) enrollees aged 65 or older. We included people with one incident primary, malignant cancer diagnosed between 2005 and 2011, surveyed within 2 years after diagnosis (n = 9,800; 995 dual enrollees). Medicare CAHPS measures included 5 global ratings and 3 composite scores.


After adjustment for potential confounders, people with cancer histories who were dually enrolled were significantly more likely to report better experiences than non-duals on 2 measures (Medicare/their health plan: adjusted odds ratio [aOR]: 0.68, 95% confidence interval [CI] 0.53–0.87; prescription drug plan [PDP]: aOR: 0.54, 95% CI 0.40–0.73).


Dual enrollees with cancer reported better experiences than Medicare-only enrollees in terms of their health plan (Medicare FFS or Medicare Advantage) and their PDP. Better ratings among dually enrolled beneficiaries suggest possible divergence between health outcomes and care experiences, warranting additional investigation.


Dual eligible Poverty Medicare Medicaid Cancer Patient experience 



Funding for this research was provided to LML, JC, and MTH under National Cancer Institute Contract #HHSN-261–2015-00132U.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.

Supplementary material

10552_2019_1218_MOESM1_ESM.docx (160 kb)
Supplementary file 1 (DOCX 160 kb)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.RTI InternationalWalthamUSA
  2. 2.University of Massachusetts Medical SchoolWorcesterUSA
  3. 3.Cancer Control and Population SciencesNational Cancer InstituteBethesdaUSA
  4. 4.Gillings School of Public HealthUniversity of North Carolina - Chapel HillChapel HillUSA

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