The patient perspective of health care access and quality is an important component of assuring patient-centered and value-based care. Although Medicare regularly administers the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) patient surveys among Medicare beneficiaries overall, very little research has examined rural/urban disparities in the patient perspective of health care access and quality among Medicare beneficiaries with a history of cancer.

Incidence and mortality rates remain higher among rural residents for two cancer sites in particular—colorectal (i.e., colon and rectum) and lung (i.e., lung and bronchus). Because incidence and mortality rates for colorectal and lung cancer are higher among rural relative to urban residents, a key concern is whether rural cancer patients experience problems accessing health care and receiving care coordination relative to urban cancer patients.

We hypothesized that rural cancer patients have lower (worse) ratings and reports of their health care access and quality, even when adjusting for other factors. We further hypothesized that rural minority cancer patients have lower (worse) ratings and reports of their health care access and quality than rural White cancer patients, even when adjusting for other factors.

This project provided timely information about rural/urban and racial/ethnic inequities in health care experiences among Medicare beneficiaries with cancer. The findings may be applied by CMS and other federal policy makers to incentivize improvements in health care delivery and thereby reduce rural/urban and racial/ethnic inequities in cancer care among Medicare beneficiaries.

Publications

• Satisfaction With Care Among Cancer Survivors With Medicare Coverage: Are There Rural vs. Urban Inequities?
  Journal Article
  Rural and Underserved Health Research Center
  Date: 03/2024
  This article examines satisfaction with health care among rural vs urban Medicare cancer survivors. Researchers looked at nine dimensions of health care and tested for rural/urban differences, adjusting for demographic factors, health insurance, and self-rated health.