Healthcare Plan And Provider Ratings Among Cancer Survivors.

9579 Background: Providing optimal healthcare for cancer survivors is important to address symptoms from cancer and cancer treatment, reduce risks of subsequent cancers, and improve quality of life. However, little is known about patient-level factors influencing ratings of healthcare plans or providers by survivors. Methods: This study used ratings provided by cancer survivors in the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Medicare Survey linked to data from NCI’s Surveillance, Epidemiology, and End Results (SEER) Program (SEER-CAHPS). CAHPS data on self-reported general and mental health status and three rating categories (overall care [OC], physician [MD], and healthcare plan [HP]) were linked to SEER data on patient sociodemographics and cancer characteristics. Medicare beneficiaries diagnosed with cancer in SEER regions 1997-2011 who participated in the CAHPS Medicare Survey at least one year after cancer diagnosis were included. The study included only individuals alive at least one year following CAHPS survey completion, age >66, and diagnosed with non-metastatic breast, colorectal, lung, or prostate cancer. Results: We identified 23,969 cancer survivors with linked SEER-CAHPS data. Higher self-rated general health was largely associated with higher ratings for OC, MD, and HP for all four included cancer types. However, other factors significantly associated with ratings tended to differ by both rating category and cancer type (see table). Time since diagnosis and type of Medicare plan (FFS vs. HMO) were not significantly associated with any ratings. Conclusions: Beyond self-rated general health, survivor characteristics predicting higher ratings varied substantially by cancer and rating type. These results suggest that the experience of care among cancer survivors is diverse and is significantly influenced by their cancer type. Efforts to improve care for cancer survivors will need to be tailored for each survivor group. Significant (p<0.01) predictors of higher (+) or lower (-) CAHPS ratings. Breast Colorectal Lung Prostate OC MD HP OC MD HP OC MD HP OC MD HP Higher Mental Health + + + + + Older Age + + + + Asian - Black + + Hispanic + + College Graduate - - - - - - Stage 2/3 at Dx + + + Yrs Since Dx FFS healthplan