For decades, October has been recognized as Breast Cancer Awareness Month — a time to go pink to help increase awareness, promote early detection and prevention, and support those battling the disease that affects 2.3 million women around the world each year.
And yet, even though pink, and therefore breast cancer awareness, is at the forefront of our minds in the fall, there’s still so much work to be done to ensure community education resonates and individuals access potentially life-saving preventative care in time. At CarelonRx and Carelon Research, we wanted to understand how these messages were translating into engagement of preventive care for breast cancer in the real world.
The combined Carelon team looked specifically at commercially insured women who were at least 45 years old (of note, the new U.S. Preventive Services Task Force recommended age for mammograms is 40). Within our internal data, from 2020-2021, there were 2.1 million commercially insured women eligible for mammograms, but only 62% had received the preventative screening. Our internal data also highlighted that there were inequities in screenings by socio-demographic characteristics. Particularly, there was a disparity within geographical regions of the country. Of those in the western part of the United States, only 53% received mammograms. In some cases, women living in adjacent zip codes within the same metropolitan areas had wide variability in screening rates.
To make these data actionable, we created zip code-level heat maps that highlighted specific zip codes where high numbers of women had not received a mammogram screening. Four states — California, Virginia, Georgia, and Wisconsin — had the greatest geographical disparities in screening rates.
We are now collaborating with like-minded life sciences partners to provide targeted interventions within these high-need areas. These multi-pronged interventions include having conversations with health care providers, local cancer societies and community partners within high-need zip codes who can provide local outreach and preventative intervention efforts to help increase preventative screening rates. We find there are several ways those of us in healthcare can help spot care gaps, promote preventative care, and ultimately better health outcomes in our communities:
- Be curious: Start by asking a question. For us at Carelon, we were curious: “I wonder how many of our eligible members actually go and get their mammogram when it is recommended that they do? Who needs the most help scheduling and getting their mammogram on time?” From there, lean into your data to develop an answer to your question. That basic curiosity can help spot gaps in care you didn’t even know existed or needed solutions.
- Partner: This work can’t be done alone or in silos. After asking the question and analyzing the data, work to develop a solution that may overcome that gap in care. We must work together — payers, providers, pharmacists, and health systems — to make a meaningful difference in the lives of our patients and members. This collaboration might look like a payer identifying and sharing zip codes where there are gaps in care so the local health system can dispatch their mammogram bus to those specific communities. Perhaps it’s a provider sharing unidentifiable, anecdotal stories of what they are seeing in the clinic to help payers provide resources that reduce barriers to preventative care. For example, within our Carelon collaboration, Carelon Research extracted and analyzed data from within their data environment, and then CarelonRx had conversations with their network of pharmaceutical manufacturers and providers to help raise awareness of the zip codes that needed more accessible and convenient preventable breast cancer care.
- Evaluate: It sounds simple, but we must find time to consistently evaluate data and create solutions. After establishing partnerships and implementing a solution to the gap in care, evaluate the results. Ask yourselves, “What’s working well? What needs to change? How can we make this better for our patients and members?”
This October, in recognition of Breast Cancer Awareness Month, we invite you to join us in creating innovative ways to leverage our collective expertise to promote preventative breast cancer care and improve health outcomes.
Hani Sefain, PharmD, is director of pharmacy at CarelonRx; and Jay Visaria, PhD, MPH, is director of pharmacy economics at Carelon Research. Carelon is a part of Elevance Health.
