Blue Cross Blue Shield of Massachusetts Launches Blue Care Connection for Breast Health.

BOSTON -- Working with the American Cancer Society, Blue Cross Blue Shield of Massachusetts (BCBSMA) is reaching out to members who are in the earliest stages of breast cancer diagnosis and treatment. The Blue Care(R) Connection for Breast Health gives members a single point of contact with a BCBSMA case manager who is a registered nurse. The case manager can support their diagnostic needs and treatments identified by their physicians.

"In Massachusetts, 5,170 women will be diagnosed with breast cancer this year. The earlier breast cancer is found, the better the chances that treatment will work. The American Cancer Society is proud to work with Blue Cross Blue Shield of Massachusetts as the patient support partner in this multifaceted outreach initiative," said Janet McGrail, Massachusetts Vice President for Cancer Control, American Cancer Society. "Together, we are reaching out to women raising the awareness of early detection, which is a woman's best defense against breast cancer."

"Part of BCBSMA's overall strategy includes addressing the health care needs of our members--from the very healthy to the chronically ill. As part of this strategy, we offer our Blue Care(R) Connection for Breast Health program that supports two groups of eligible members: those who are not receiving regular mammograms and those who have recently been diagnosed with breast cancer," said John A. Fallon, M.D., Chief Physician Executive. Dr. Fallon said the program has helped nearly 500 women since April.

The federal Centers for Disease Control and Prevention says that the five-year survival rate for localized breast cancer is 97 percent--if the disease is detected early enough. Breast cancer is the second most commonly diagnosed cancer among American women, behind skin cancer. Only lung cancer takes more lives. In 2003, about 211,000 new cases of invasive breast cancer were diagnosed nationwide, and an estimate 39,800 died of the disease.

The Blue Care(R) Connection for Breast Health has two member tracks: early detection and rapid treatment. To promote early detection, BCBSMA will send a letter to members age 50 and older who have not had a mammogram in the past three years to encourage them to schedule one. Later a BCBSMA Member Service associate will follow up with them.

The Member Service associate calls these members to identify barriers to getting the mammogram, to provide benefit and coverage information and to offer to schedule an appointment. If a member chooses not to make an appointment at that time, BCBSMA will send the member a toolkit with educational resources from the American Cancer Society.

For BCBSMA members who have had a positive breast biopsy, the company will give each member a single point of contact at BCBSMA who can to help solve any problems related to diagnostic needs or accessing treatment identified by their physicians. BCBSMA nurse case managers call these members to assess their health status and needs, to offer educational materials and information and to offer to help navigate through the health care delivery system from diagnosis through treatment.

After receiving the physician's approval, the BCBSMA nurse case manager will interact with member to help them navigate the health care system. The nurse case manager also sends the member a toolkit of resources, including a National Cancer Institute booklet, a journal to document the member's care and a toll-free number to call if the member has any other clinical questions. The nurse case manager provides consistent support by telephone for three months. At the six-month mark, the nurse case manager places a follow-up call to the member to check progress, to answer any questions and to identify new barriers to care.

Blue Care(R) Connection for Breast Health works with physicians through consulting and education. BCBSMA's Regional Medical Directors will visit physicians with lower than average mammography rates for their patients. The BCBSMA physicians will visit these doctors' offices to give the physicians a list of patients overdue for the mammogram and will consult with the physician to identify any cultural or societal barriers for these patients. BCBSMA will work on any systemic issues, and will offer solutions for improvement. BCBSMA also has a toolkit of mammography resources--including office and patient education - for the physicians' practice.

Dr. Fallon said in the program's first seven weeks, the response from BCBSMA members has been extremely positive. Members say it was nice to have someone from the insurance company to contact with any questions. They enjoy the support and find the literature very informative and helpful, he added.

Blue Cross Blue Shield of Massachusetts (www.bluecrossma.com) was founded 66 years ago by a group of community-minded business leaders. Today, headquartered in Boston, BCBSMA provides coverage to 2.6 million members. Consistently recognized for standards of service that are among the highest in the nation, Blue Cross Blue Shield of Massachusetts is the choice for health care consumers seeking reliable and high quality health care coverage. Blue Cross Blue Shield of Massachusetts is an independent licensee of the Blue Cross Blue Shield Association.