According to 2015 data*, the incidence of breast cancer in Rhode Island for females of all races was 135.3 per 100,000. This figure is comparable to national statistics for the same year; however, opportunities remain for early detection and treatment of breast cancer.
BCBSRI’s Well Adult clinical practice guidelines are derived from the U.S. Preventive Services Task Force guidelines and contain guidance on screening for breast cancer in women. The following recommendations pertain to women not at an increased risk of breast cancer due to a known genetic mutation or history of chest radiation:
Please note: HEDIS excludes Medicare members age 66 and older as of 31 de dezembro of the measurement year who are:
- Diagnosed with frailty and advanced illness during the measurement year.
- Enrolled in an Institutional SNP (I-SNP) any time during the measurement year.
- Living long-term in an institution (LTI) any time during the measurement year. – Organizations may use the LTI flag in the Medicare Part C monthly membership file.
Mammograms are a covered service for BlueCHiP for Medicare and Commercial members. Mammograms performed as preventive are covered at 100% according to the Affordable Care Act (ACA). Benefit coverage for diagnostic mammograms varies according to the member’s coverage. Please encourage members to obtain their mammograms according to the clinical recommendations for their age, risk level, and circumstances.
Whether members in your practice are coping with breast cancer, or are newly diagnosed, they may seek recommendations for support services in the community to supplement their medical care. The following is a list of local organizations that can provide information, advocacy, and support regarding breast cancer:
- American Cancer Society, Rhode Island Chapter: Call (401) 243-2600. Cancer Information Specialists can also be reached 24 hours a day at 1-800-227-2345
- Breast Cancer Council of Rhode Island: Call 1-800-216-1040, or email ribcc@aol.com.
- Gloria Gemma Breast Cancer Resource Foundation: Call 401-861-HERO (4376) or email info@gloriagemma.org.
You can also refer these members to our Care Coordination program, which can help members coordinate these screenings and meet other health goals. You can reach Care Coordination by calling 401-459-CARE (2763) or by emailing triage_group@bcbsri.org.
*State Cancer Profiles. Quick Profiles: Rhode Island. National Institutes of Health; 2018. Available at: State Cancer Profiles Site