Tackling inequities in breast cancer detection

Orriel Richardson , Vice President, Health Equity & Policy at Morgan Health explains the “weathering” effect racism and discrimination can have on a person's health, and the opportunity for health plans to adapt to a patient’s individual circumstances.??

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What’s top of mind for you for this Breast Cancer Awareness Month??

Gratitude and amazement. I remain eternally grateful that my mother and two aunts are healthy after each was successfully treated for post-menopausal breast cancer. I’m also amazed by the technology and clinical advancements in this space after seeing 5 of my former classmates – generally between 35 and 42 years of age – receive life altering diagnoses, undergo less invasive treatment than I recall for my loved ones, and enter remission.??

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How do health inequities impact breast cancer outcomes??

I attribute many disparities that show the biggest, most adverse impact on Black women, to the concept of “weathering.” Research by Professor Arline Geronimus suggests people from historically marginalized communities experience significant stressors as a result of racism and discrimination, and that these stressors can affect their bodies at a cellular level. There are also gaps in coverage policies that have bearing on accessibility to and affordability of detection and screening. For example, women with denser breast tissue are usually required to have two or three additional, higher resolution imaging services beyond the baseline, biennial mammogram that is covered at 100%. Those with a history of breast cancer in their families are recommended to be screened annually, but coverage may not cover yearly mammograms, let alone a yearly MRI. Finally, the cost of adopting the latest technology and innovations can impede uptake in under-resourced communities, especially rural areas.?

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What opportunities are you seeing in the space??

I see an opportunity for coverage policy to evolve and adapt to a patient’s unique circumstances. It is highly beneficial to patients, and insurers’ bottom lines, to cover the maximum number and types of screening/detection services as preventive (i.e., without cost sharing) based on that patient’s unique circumstances.?

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How do value-based care models support early detection??

Practically, a value-based care arrangement can help ensure a patient is current with all recommended screenings. Theoretically, it could pursue arrangements with imaging providers to underwrite the cost of higher resolution screening and detection methods across a larger population than would actually need to utilize those options. Finally, if the theory bears out, the value-based arrangement would also help mitigate cost constraints and further support early detection and treatment.?