HFS
To reduce disparities in breast cancer detection and treatment for Medicaid beneficiaries
The purpose of the HFS project
Patient saw their PCP last week
Ask if they have a mammogram referral,
Request mammogram referral
Patient: I don't speak English, English is not my first language, I need an interpreter
Language
Member is interested in getting a mammogram done
Schedule in Process
Patient never had a mammogram and is worried about the pain
Open ended.
Answer along the lines of: Early detection, display empathy, share personal experiences, be honest and acknowledge their fears
What do we do after we attempted to contact a patient 3 times and have not received a response?
Send a no contact letter and close the case
Patient: I haven't seen a PCP in over a year
Establish Care Visit, Primary Care Appointment
Patient: I don't have a car, I have to ask for a family/friend to take me to my appointment
Transportation
Member has passed away. What is the outcome?
Unable to schedule
Patient is on the fence about getting a mammogram she is concerned about the radiation. What do you say to help ease the concern?
Open ended.
Answer along the lines of: Radiation is very limited, discuss facts vs. myths
Which health care plans does HFS work with?
Aetna, Blue Cross Blue Shield, County Care, Meridian, and Molina
What causes delays in scheduling a mammogram once a referral has been received?
Appointment wait times at certain facilities
Patient: My mother is terminally ill and I have no one to take care of her, I'm her primary caregiver and my priority is to care for her
Personal / Family Obligations
Member stated they are not at home and are busy
Unavailable
Patient states she had a mammogram 2-3 years ago, why does she need to get it again?
Open ended.
Answer along the lines of: Discuss education, importance of early detection, annual screening
Who is our target population for the HFS project? (3 part answer)
Members ages 40-65
Members who have not had a mammogram in 18 months
Members who reside in the South and West side zip codes
Who do you reach out to at the facility to provide support when a patient is diagnosed?
Facility oncology social workers
Patient: I have an upcoming surgery, I already have to see other specialists, I have other health issues that are more important than a mammogram
Co-morbidities
Member lost their insurance and no longer has Medicaid
No Longer Member
*Refer to IBCCP if member is interested
Patient is due for a diagnostic mammogram but states she does not want to do it again she is scared of the results. What do you say to help her make that appointment?
Open ended.
Answer along the lines of: Discuss how common diagnostics are, the procedure, emotional support
Why was the HFS project created? Why were these areas chosen?
Women in the designated zip codes had gone 18+ months without a screening
Women in the designated zip codes were falling through the care gaps
Patient Navigation Key Responsibilities
Patient: I saw on Facebook that mammograms give you cancer from the radiation, they hurt too much, my friend said it was so painful and it gave them cancer
Fear / myths
Member tells you they don't want a mammogram, and she does not believe in mammograms, asked you to stop calling
Refused
Patient had a biopsy and it came back positive. Patient reviewed her results and is aware it is cancer. How do you respond as a navigator?
Open ended.
Answer along the lines of: Express empathy, follow up with who she has met with, ask if she's discussed treatment, follow up if she has any additional appointments since her results, inform her that you are there to support her throughout this process.