Comprehensive Breast Care Programs Facilitate Wellness and Disease Prevention

As health care organizations evolve and focus more on wellness, disease prevention and care coordination, some have integrated women’s health and breast cancer services into a comprehensive breast care program as a way to gain market share, strengthen patient loyalty and increase revenue.

Successful breast health programs deliver coordinated services for screening, diagnosis and therapy, emphasizing accessible, high-quality services and accountability across the episode of care. Accountability for cost and quality will have broad implications as organizations become more responsible for the consequences of false-positive results, overdiagnosis and overtreatment and will also inform decisions about the deployment of novel technology.

There is no uniform model for a comprehensive breast care program—organizations considering this offering should evaluate their market landscape and organizational strengths to determine the right service mix.

Trends in Breast Health Services
The number of women receiving breast health services is expected to grow significantly over the next 10 years as the US general population ages. However, Sg2 is projecting slower growth during this period in screening and diagnostic services—specifically mammography, biopsy and evaluation and management (E&M) visits—due to the adoption of better screening and diagnostic technology (namely, tomosynthesis) and evolving screening guidelines that recommend a longer interval between screening exams or beginning screening at an older age.

The variation in screening recommendations from organizations such as the American Cancer Society and US Preventive Services Task Force (USPSTF) has caused confusion among patients and physicians, which Sg2 anticipates will reduce the overall number of screenings. This trend is reflected in our breast health services forecast, summarized in the table below.

Technologies are also expected to impact future utilization of breast health services. New imaging modalities such as tomosynthesis (a 3D image of breast tissue that allows for better analysis of masses, even for patients with dense breast tissue) impact downstream care utilization. Center-specific studies have found that adding 3D mammography can lead to a nearly 50% decline in callbacks for biopsy. Breast tomosynthesis will be increasingly integrated into breast cancer screening, displacing significant diagnostic volumes and softening demand for biopsy.

Strategies for a Successful Breast Health Program

  • Create a strong program vision that includes defined goals and scope of services. Identifying what services are currently available and where they are located will be critical when determining whether a physical structure is best for the breast cancer program or whether the program will be virtually integrated with services offered across various sites.
  • Employ the appropriate specialists. Comprehensive breast cancer programs typically include medical and radiation oncologists; breast surgeons and plastic surgeons; pathologists; and radiologists. In addition, ancillary staff often includes nurses (clinical and/or research); nurse/patient navigators; nutritionists; rehabilitation specialists; genetic counselors; sexual health specialists; oncology pharmacists; and social workers.
  • Include navigators to help integrate care and services along the care continuum. Navigators ensure patients are prepared for treatment and boost patient satisfaction by providing education and psychosocial support. They also facilitate interaction between patients and their physicians, provide logistical support, secure referrals and assist with financial and insurance issues.
  • Offer additional services that may be aligned with traditional women’s health and wellness programs to support the traditional cancer care path. These services may include complementary and alternative medicine, pain management/rehabilitation, lymphedema clinic, active clinical research trials, behavioral health, integrative services, and retail products.
  • Differentiate from competing facilities by serving as a “destination” for breast care services and improving the patient experience. Easy parking, extended hours (particularly early morning and evening appointments), on-site child care services and “packages” that include hotel services for traveling patients can help increase the center’s appeal.
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