Project Summary: Overcoming Cost-Related Fears as a Barrier to Breast Cancer Treatment

Category: Health Outcomes

Scholarship Recipient: Yes

Background: Excluding skin cancers, breast cancer is the most frequently diagnosed cancer in women, with one out of eight women nationally – and one out of seven women in Colorado – being diagnosed with the disease throughout her lifetime. The American Cancer Society (ACS) projected that 3,780 Colorado women were expected to be diagnosed with breast cancer in 2014 alone, with 530 Colorado women expected to die from the disease. Certain provisions of the Affordable Care Act have increased the likelihood that more Coloradans can access the breast cancer services they need to increase survivorship rates when diagnosed with the disease.

Objective: This project will allow Colorado residents to seek breast cancer care at high-quality facilities by understanding ranges of costs by region and facility. This project will apply specifically to breast cancer providers within this state, including rural areas and towns on the western slope where care is limited and there are lower rates of early detection and treatment, and higher mortality rates. Providing this information to Colorado residents will allow them to seek treatment at facilities that provide the best care, at the best price. Coloradans will be able to search for the cost of breast cancer care at the facility of their choice and be better informed about potential costs of care for facilities/providers that are in-network versus out-of-network.

Methodology: Komen Colorado received a customized data report from CIVHC to assess variances in costs for medical procedures and pharmaceutical claims to screen for, diagnose, and treat breast cancer in Colorado. Komen Colorado received data to analyze differences in costs across payer types (Medicaid, Medicare and commercial payers), as well assess cost-sharing between insurance carriers and covered individuals.

Data Analyzed: 2013-2014 claims data (all lines of business), female only claims

In progress.

Komen anticipates releasing region-specific summaries of costs of care by Health Statistics Region for both medical and pharmaceutical claims. Komen Colorado is working on analyses of cost variances based on complexity of treatment plans – such as whether a patient receives only surgery or receives surgery, chemotherapy, radiation, and multi-year hormone therapy to reduce risk of recurrence. Komen seeks to educate consumers about the correlation between the invasiveness of breast cancer and the associated costs of successful treatment.