Women with breast cancer treated at high Medicaid burden hospitals were less likely to be offered immediate breast reconstruction (IBR), according to a cross-sectional analysis involving >30,000 individuals from nearly 1,200 hospitals. Moreover, their treatment costs were higher. Investigators determined hospital Medicaid status and looked at its link to IBR use, outcomes, and costs. Among the results:

• Patients with in situ disease and/or an elevated risk of cancer treated in Medicaid burden hospitals were 36% less likely to undergo IBR.
• Lower odds of IBR were seen in older individuals, patients who were obese, and those who had government insurance.
• The same was true for nonwhites and those with comorbid conditions.
• In-hospital surgical and medical complication rates were comparable across the 3 levels of hospital Medicaid status.
• Costs of care were positively linked with a higher hospital Medicaid burden status for medium and high Medicaid burden hospitals.