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| Home > Healthy People > December 2001 |
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January - March, 2002 |
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Cancer screening program offers financial help
Cancer screening program offers financial help
Organizations concerned with increasing
cancer mortality rates advocate no-cost screenings for women
When a patient is diagnosed with cancer, the experience is often a traumatic one. However, the scariness and uncertainty of the situation is compounded for those who don't know how they will pay for treatment.
Fifty-four-year-old Ruby James of Macks Creek went through this experience last year.
James, who has a family history of cancer, mentioned she had been having pain in her breast and under her arm to her primary care physician in Buffalo during a routine check-up.
"I didn't think I had cancer." James says. "I told my husband about the pain and my family members seemed to think that wasn't what it was, so I didn't either."
The physician referred James to surgeon Karen Tabb, D.O., of Lebanon Surgical Center. Because James had never had a mammogram, an ultrasound was performed at St. John's Breast Center. A biopsy followed, and the result was malignant. Tabb recommended a mastectomy.
"I immediately thought this is not fair I felt that I was too young to die, but I didn't want to have the surgery because I didn't have any way of paying the bills. I didn't want to tell anybody what was happening. When I visited Dr. Tabb after the biopsy, she told me about the National Breast and Cervical Cancer Early Detection Program."
The 11-year-old program is a cooperative effort by the state and federal government and the Centers for Disease Control and Prevention and provides uninsured or underinsured women with mammograms and cervical cancer screenings and treatment. To date, the NBCCEDP has provided more than 2.7 million screening examinations and diagnosed 8,600 breast cancers, 39,400 precancerous cervical lesions and 660 cervical cancers. The program operates in all 50 U.S. states, the District of Columbia, six U.S. territories and 12 American Indian/Alaska Native organizations.
"Part of obtaining good health care is having the resources to pay for the services," Tabb says. "Women know they need health care, but they also think that they can procrastinate and wait until they have the resources to pay for it."
According to Elisa Coonrod, regional case manager for NBCCEDP program, the NBCCEDP is a result of the Breast and Cervical Cancer Mortality Prevention Act of 1990.
"This legislation was a result of advocacy efforts of women's groups and other organizations," Coonrod says. "These organizations, such as the American Cancer Society, were concerned with the increasing mortality rates of these cancers."
Peggy Daniels, who manages St. John's Lebanon Surgical Center, says the program provides Missouri women health care that they might otherwise be denied because of financial reasons.
"This health care is administered through the local health departments in each individual county throughout Missouri," Daniels says. "The system targets women who do not qualify for Medicaid but cannot afford private health insurance for their yearly Pap smears or mammograms. This is a screening program only. If a woman is found to have an abnormal result, the health department refers the patient to a doctor who will accept NBCCEDP payment, which is below the contracted rates. The reimbursement isn't great, but women are being taken care of."
St. John's Breast Center Director Sharon Davis, R.N., says the Breast Center has accepted NBCCEDP reimbursement since 1996.
"We accept health department referrals from any health institution that accepts the program's reimbursement," Davis says. "The patient never receives a bill because we send it directly to the agency."
The Breast Center provides screenings, diagnostics, ultrasounds, core biopsies, and education. Davis adds that the Breast Center does not have the authority to agree to reduced reimbursement for breast procedures that are not performed at the Breast Center, such as excisional breast biopsies or tests that are performed in the lab or pathology departments, nor does it have the authority to accept payment for cervical procedures covered by the program.
"The Breast Center is continually working collaboratively with the NBCCEDP staff to improve the process of referring women to our services under the program. We can detect cancers earlier with screening and this will decrease morbidity and mortality."
James says she now has a new lease on life and has used this opportunity to become closer to her family and to God.
"Because the physicians at St. John's were so very nice and took care of me, I can appreciate life. All of the small things such as my car or my favorite dress didn't mean anything anymore. I was very bitter, but I turned things around. God says that all things work for the good, and I have made amends that should have been made a long time ago," she says.
Coonrod adds the midwest is in desperate need of more providers who will accept NBCCEDP payment.
"While St. John's is a big help to this area, there are still not enough physicians that will accept this form of payment," Coonrod says. "The program suggests women get a clinical breast exam every year, do a breast self-exam every month, get a mammogram every year if you are age 50 or older, and get regular Pap tests and pelvic exams."
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