Karmanos Cancer Institute and Wayne State University review of breast and cervical cancer screening program highlights need to address economic challenges of uncompensated care

Robert Burack, M.D.

With approximately 44 million Americans uninsured, health care systems and providers bear much of the financial burden by providing unreimbursed services. The absence of health insurance is a major impediment to receiving preventative health care as well as other health care needs extending beyond prevention. According to a study done at the Karmanos Cancer Institute, Wayne State University’s School of Medicine and Henry Ford Health System, the success of targeted programs in addressing some of these preventive needs may nevertheless leave other health care needs unaddressed. Little is known about the magnitude of the additional costs that might be incurred by participating health systems – this study aimed to begin to comprehend this growing problem. To better understand the potential financial impact health systems endure, Robert Burack, M.D., professor of internal medicine at Wayne State University and the Karmanos Cancer Institute, and Elston Lafata, M.D., of the Center for Health Services Research at Henry Ford Health System, have published an analysis in the recent issue of the Journal of Health Care for the Poor and Underserved. It focuses on the cost of health care services provided to women enrolled in a community-based breast and cervical screening program. The Wayne County Breast and Cervical Cancer Control Program provides breast and cervical cancer screening, follow-up and treatment services for uninsured and underinsured low-income women ages 40 to 64. Developed and funded through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and Michigan Department of Community Health, the program is designed to provide only breast and cervical services and thus other types of care are not reimbursed through the program. All clinical services are delivered by participating health care organizations who determine which, if any, additional services to provide to program enrollees. The study found that nearly 50 percent of the total cost of care provided to those enrolled in this program was uncompensated, with about 15 percent being paid for by the Breast and Cervical Program and the remainder from other sources. The NBCCDEP has benefited tens of thousands of women each year. As successful as the program has been in accomplishing its breast and cervical cancer control objectives, it was not designed to meet other health care needs of enrollees. Those health care providers who choose to participate are then faced with the challenge of determining whether and how to address these needs. “This program’s success in providing access to health care for underserved women highlights the economic challenges of uncompensated care already faced by health care providers serving disadvantaged communities,” said Burack. “Until the larger issue of no or inadequate health insurance is addressed, the unmet health care needs of the uninsured will grow, while the capacity of already challenged safety net providers to meet this need will decline.” To review the full paper, click here.
Source:
1. Karmanos Cancer Institute and Wayne State University review of breast and cervical cancer screening program highlights need to address economic challenges of uncompensated care