Increasing access to breast cancer screenings in rural, underserved areas


For breast cancer, early detection via mammography screening and subsequent treatment can save lives. Breast cancer is one of the most common cancers in women in the U.S. The U.S. Preventive Services Task Force recommends that women between the ages of 40 to 74 undergo mammography screening every other year.

However, it can be difficult for women in underserved and rural communities to get access to mammograms because of an overall lack of providers in the area. What’s more, social drivers of health, particularly a lack of transportation, can exacerbate this crucial piece of preventive care for women. Rural screening rates nationally are often lower than they are in urban areas.

In Cowlitz County in Washington state, The Cowlitz Family Health Center, a local federally qualified health center (FQHC), and the PeaceHealth St. John Medical Center Kearney Breast Center, as well as the UnitedHealthcare Community Plan of Washington, sought to close these gaps and make sure that women were able to get the preventive care they needed.

The collaboration begins with claims data provided by UnitedHealthcare to help find members who need mammograms. PeaceHealth mammography coordinators then reach out to these women to help them schedule services. The Cowlitz Family Health Center helps provide assistance and support, following screening results. The FQHC’s role is to ensure members are receiving timely access to care with a deliberate focus on quality and equitable services. The three organizations work closely together to proactively look at potential barriers and identify solutions, as well as discover additional resources when needed. Nonemergency medical transportation (NEMT) can also be provided under the state Medicaid plan.

“This project has been and continues to be very important to PeaceHealth Kearney Breast Center. The partnership with UnitedHealthcare has allowed us to reach out to, and provide a very important service to a population that is many times underserved,” said Gretchen Vanden Berg, imaging manager at the PeaceHealth St. John Medical Center Kearney Breast Center.

So far, more than 340 mammograms have been completed by PeaceHealth for UnitedHealthcare Community & State members, and of these, 197 are for Cowlitz Family Health Center members, with the FQHC evaluating outcomes and providing follow-up where needed.

“This project has allowed us to improve population health management through supporting access to care and timely delivery of mammography services,” said Wesley Jordan, clinical practice consultant for UnitedHealthcare, who helped design this program. “Through this work, more women are receiving potentially lifesaving screenings.”

Future plans for the project include further expansion and broader availability of mammography services — for example, on the weekend — with available transportation, making it easier for women to get much-needed screenings.

“Barriers are being dismantled to secure members’ consistent access to exceptional services, thus ensuring equitable care,” Wesley said. 

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