To describe cancer prevalence, mortality, health care utilization, and spending among American Indian and Alaska Native beneficiaries enrolled in traditional fee-for-service Medicare.
Approach:
Study design and data: Multiyear cross-sectional study using nationwide, deidentified Medicare claims and prescription drug data from 2016 through 2023.
Population and measures: Cancer prevalence required at least two linked cancer-diagnosis claims in a year. Mortality was annual all-cause mortality; utilization and spending were assessed from Medicare claims.
Key Findings:
In 2023, 123,597 American Indian and Alaska Native beneficiaries were included, representing 0.5% of the traditional Medicare sample.
Compared with the overall beneficiary population, American Indian and Alaska Native beneficiaries more often were younger than 65 years (24.9% vs 4.1%), qualified through disability or end-stage renal disease (40.1% vs 17.8%), and were dual eligible for Medica…
Cancer prevalence in 2023 was 10.8% among American Indian and Alaska Native beneficiaries and 19.4% in the overall population.
In 2023, all-cause mortality among American Indian and Alaska Native beneficiaries with cancer was 12.4%, the highest rate across demographic categories (RR, 1.80; 95% CI, 1.72-1.88), down from 12.7% in 2016.
Interpretation:
The reported Medicare claims data show lower cancer prevalence but higher all-cause mortality among American Indian and Alaska Native beneficiaries with cancer than in the overall traditional Medicare population in 2023.
Limitations:
The study included traditional fee-for-service Medicare beneficiaries and may not represent people outside this coverage.
Medicare claims did not identify cause of death; mortality therefore reflects all-cause mortality.
Cancer prevalence depended on linked diagnosis claims, and race information included imputed values for some beneficiaries.
