Accelerating cancer screening - wellspace health and U.C. Davis health comprehensive cancer center (NCI-designated cancer center) will address breast cancer in the greater sacramento county region

The project will increase breast cancer screening and referral for care and treatment through community outreach, patient navigation, and medicaid enrollment. During the 2021 year, 9,092 wellspace health (WSH) patients who access primary care services qualified for a mammogram according to universal data set (UDS) reported to the U.S. Health resources services administration (HRSA). WSH provided 2,751 patients with a completed mammogram screening, which is 30% of qualified patients. Therefore, 6,341 patients who qualified for a mammogram went without. Patients have responded that they did not get a mammogram due to inability to get time off work, lack of time due to family obligations, a lack of transportation, and disbelief in the need the test. The wellspace health breast cancer screening, care, and treatment program will improve breast cancer screening rates for qualifying patients while expanding screening and care to new patients and those who may not have been identified as meeting criteria for a mammogram. WSH will specifically seek to improve screening rates among those who are uninsured and those who are experiencing homelessness. Approximately 15% of WSH patients remain uninsured. WSH will utilize internal referrals to new mammography screening for these individuals, recognizing that the out-of-pocket cost of accessing care with a referring provider presented significant (if not absolute) barriers to care. Further, grant funds will be budgeted to cover the uncompensated cost of screenings at U.C. Davis for those with abnormal breast cancer screening findings. WSH uses the population health management tools in nextgen to better identify and engage women who meet criteria for cancer screening. Additional care team training will be provided to improve utilization of the quality template to ensure they can easily see when a patient is due for a mammogram when they seek care for other reasons. To ensure there are no missed opportunities, patients will be allowed to access same-day walk-in mammograms without a referral. For those patients who miss appointments, the WSH patient portal, text messaging, and follow-up calls will be utilized to reschedule their screening/follow-up visit and increase rates of screening, care, and treatment. The WSH breast cancer screening team consists of a project manager, outreach coordinator, and interns. The WSH team will coordinate its activities with the UC davis team. Both teams will conduct breast cancer screening outreach, health system navigation, public health insurance enrollment, follow-up appointments, care, and treatment. Breast cancer screening will continue after the two-year grants funding. Building on the program designed under this grant opportunity and utilizing new mammogram equipment, wellspace health will continue to onboard volunteers to facilitate personalized phone calls. In addition, text message campaigns will be used based on best practices established in the program period. Mammogram events will continue to be held in local communities where the highest number of patients are due for a mammogram. Further, using the patient activate automated breast cancer screening engagement with patients will continue.