Evaluation of California’s Housing for a Healthy California Program, January 2024
Published Date: June 01, 2020

​Summary: Metastatic Breast Cancer (MBC) occurs across the United States, but differences in health care systems, health insurance products, and population characteristics create state-level differences in the experiences of patients. While there are national standards and laws governing different aspects of care that MBC patients receive, there is still significant impact from state-level policies. Yet, despite the intents of these regulations, a 2017 study by this research team at the UCLA Center for Health Policy Research found barriers to care for breast cancer patients still exist, some exposing a disconnect between what should be happening according to state regulations and what actually happens for some women in the doctor’s office (Ponce et al., 2018). The purpose of the current study was to identify barriers faced by women whose cancer has metastasized, and to propose possible solutions for system or policy changes that can improve care for MBC patients. This report is a synthesis of information collected from listening to patients, clinical and non-clinical caregivers, published research, the grey literature, and Twitter chat.

Findings: Based on insights from the key informant interviews, the literature review, conference proceedings, and Twitter chat, the research team identified seven typologies for categorizing barriers to care for MBC patients: financial burden, insurance, barriers, disability insurance benefits, palliative care, clinical trials, communication/information barriers, navigation and support services, and social risk factors. For each barrier typology faced by women living with MBC authors proposed policy recommendations to improve care.  

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Authors
Riti Shimkhada, PhD Susan H. Babey, PhD AJ Scheitler, EdD Beth Glenn Ninez A. Ponce, PhD, MPP