A new study by the Harvey L. Neiman Health Policy Institute has shed light on how insurance type influences treatment choices for women with uterine fibroids. The research, published in the Journal of the American College of Radiology, found that Medicaid patients were significantly more likely to receive uterine artery embolization (UAE) compared to those with commercial insurance.

The study analyzed data from 579,153 women who underwent either UAE, hysterectomy, or myomectomy, focusing on the relationship between insurance type and treatment selection. Researchers discovered that women with Medicaid were 38% more likely to receive UAE, a minimally invasive procedure performed by interventional radiologists, rather than undergoing surgery. In contrast, among women who had surgery, those with Medicaid were 20% less likely to receive a laparoscopic hysterectomy or myomectomy compared to those with commercial insurance.

Dr. Pratik Shukla, Associate Professor and Interventional Radiologist at Rutgers New Jersey Medical School, explained that gynecologists must decide whether to treat fibroid patients themselves through surgery or refer them to an interventional radiologist for UAE. Ideally, such decisions would be based solely on clinical factors rather than financial incentives. However, the study suggests that reimbursement rates may influence these choices.

Dr. Eric Christensen, Research Director at the Neiman Institute, highlighted that commercial insurance generally offers higher reimbursement rates than Medicaid. As a result, gynecologists may be more inclined to refer Medicaid patients for UAE rather than perform surgery. Similarly, Medicaid patients undergoing surgery were less likely to receive laparoscopic procedures, which typically involve higher costs and require specialized surgical skills.

While physicians do not necessarily make decisions solely based on financial incentives, Dr. Shukla emphasized the importance of discussing all available treatment options with patients. A more collaborative approach between gynecologists and interventional radiologists could help ensure that each patient receives the most appropriate care, rather than allowing reimbursement differences to shape medical decisions.

The study highlights the complex role of financial incentives in healthcare and underscores the need for policies that prioritize patient-centered decision-making over reimbursement-driven treatment patterns.

(Newswise/DN)