Healthcare organizations are striving to expand access to cancer screening beyond charity care. While free or subsidized screening events can help, the cost of treatment after a diagnosis remains a significant barrier. ChristianaCare’s partnership with the Susan G. Komen Foundation aims to address this by providing financial assistance for low-income individuals. Building patient trust and leveraging community partnerships are crucial for increasing screening rates. Transparent communication about funding options and ongoing support is essential to ensure access to care for early detection and treatment of breast cancer.
While charity care can help address some cost-related barriers to cancer screening access, healthcare organizations need to establish a more comprehensive safety net for potential cancer treatments.
Many healthcare organizations organize free breast cancer screening events as part of their charity care efforts to serve low-income and uninsured individuals. However, a critical question arises when a screening reveals a breast cancer diagnosis, leaving the person responsible for the costs of treatment.
This dilemma confronts healthcare organizations across the country that aim to bridge gaps in cancer screening through free or subsidized programs. While these screening events can increase the number of people receiving breast cancer screenings, especially among low-income individuals and people of color who often face barriers to healthcare access and may have lower levels of trust, they only address part of the problem.
The obstacle to accessing cancer screening is not solely the cost of the screening itself. When considering low-income and uninsured populations, the most affected by the cost of cancer screening, there is always the concern about the subsequent expenses: the cost of treatment if a tumor is detected.
The cost of breast cancer varies depending on the patient’s treatment plan and the stage at which the cancer is diagnosed. A 2016 study found that the average allowable cost in the first year after diagnosis ranged from approximately $60,000 for Stage 0 to $134,000 for Stage IV breast cancer, based on women with commercial health insurance.
Another analysis conducted by Bankrate estimated the cost of breast cancer without insurance to be between $10,000 and $200,000, depending on the stage of cancer. Insured individuals would typically be responsible for paying 10 to 15 percent of that cost.
Knowing the potential financial burden of cancer treatment can discourage some patients from getting screened in the first place. Nora Katurakes, RN, OCN, manager of the Graham Cancer Center’s Community Outreach & Education program, highlighted the additional treatment costs, including medications and transportation, which can deter patients when they receive a breast cancer diagnosis.
This concern is supported by data. A survey commissioned by the Alliance for Women’s Health and Prevention (AWHP) in February 2023 revealed that 14 percent of women had skipped preventive tests or screenings in the past year, with cost being a significant barrier.
Moreover, a study published in JAMA Network Open found that cost-related barriers affected patients’ adherence to follow-up cancer screening diagnostics. Patients were less likely to pursue these diagnostics when cost-sharing was required by their insurance provider.
In essence, when patients are uncertain about how they will cover the expenses of disease treatment, they may forego preventive screening altogether.
Addressing these challenges, the team at ChristianaCare’s Helen F. Graham Cancer Center & Research Institute, in collaboration with the Susan G. Komen Foundation, aims to go beyond free and subsidized cancer screening. This renewed partnership will provide diagnostic follow-up services, typically necessary after an abnormal mammogram, and establish pathways for referral into Komen’s financial assistance programs.
The key to their approach lies in providing comprehensive financial assistance. The program will be tailored to low-income individuals with household incomes at or below 300 percent of the federal poverty level, which equates to $43,740 for a single person and $59,160 for a household of two.
Katurakes emphasized that the program would also focus on reaching out to Black women in Delaware, who face a disproportionate impact from breast cancer and have lower screening rates.
Building patient trust becomes crucial in increasing baseline screening rates within these target populations. Therefore, Katurakes stressed the importance of transparently communicating the financing options for screenings, follow-up care, and treatment.
To ensure patient access, it is vital to engage community ties and raise awareness about the assistance programs. Katurakes’s team of outreach workers actively engages with the community, discussing various cancer screening topics while consistently promoting the available assistance programs.
The provision of clear patient education materials simplifies the process for individuals to reach out to the organization. For instance, resource bags containing referral materials are distributed at locations like the Food Bank of Delaware. This approach has proven successful, with individuals contacting the cancer center based on the positive interactions they experienced.
Establishing an ongoing presence in the community and collaborating with community-based partners facilitates patient navigation and scheduling of screenings. ChristianaCare’s partnerships with senior centers and religious groups, along with community-based patient navigators, ensure that people can access screenings at their convenience.
Throughout the process, Katurakes’s team emphasizes the availability of financial assistance to ensure continued access to care, especially for those receiving abnormal mammogram results. While community partners play a vital role in discussing funding options initially, it is essential to maintain communication with the providers who conduct the screenings and discuss the results with patients.
Additionally, internal education initiatives for healthcare providers at the cancer center aim to keep them informed about available resources that can assist women in taking the next step toward care.
Overall, expanding access to cancer screening requires healthcare organizations to address both the financial barriers to screening and the potential costs of treatment. By establishing comprehensive financial assistance programs, fostering patient trust, engaging community ties, and providing ongoing support, organizations can ensure that individuals receive the necessary screenings and follow-up care for early detection and effective treatment of breast cancer.
