Supporting Quality Care During Breast Cancer Awareness Month- TX Medicaid

09/28/2023

Routine screening for breast cancer is the best way to detect it early, according to the Centers for Disease Control and Prevention (CDC). Breast cancer is easier to treat when it’s caught earlier. October is Breast Cancer Awareness Month and a good time to remind our members about the importance of regular screenings for women. We’ve created resources that may help.

Screening Recommendation

Each year about 240,000 cases of breast cancer are diagnosed in women in the U.S., according to the CDC. Breast cancer death rates for women are higher than any cancer besides lung cancer.

The U.S. Preventive Services Task Force recommends that women ages 50 to 74 be screened for breast cancer every two years. You may want to discuss with members the risks and benefits of starting screening mammograms before age 50. See our Preventive Care Guidelines on breast cancer screening.

Tips to Close Gaps in Care

Talk with our members about breast cancer risk factors and the importance of regular screening for women.
Breast cancer disproportionately affects Black women, according to the CDC. Talk with our members about the unique risks and barriers they may face, which can result in poorer outcomes than other women.
Document screenings in members’ electronic medical record. Indicate the specific date and result. This helps us track member progress on the quality measure Breast Cancer Screening from the National Committee for Quality Assurance. The measure tracks women ages 50 to 74 who had at least one mammogram in the past two years.
Document medical and surgical history in the medical record, including dates. Use correct diagnosis and procedure codes. Submit claims and encounter data in a timely manner.
Offer telehealth services when available and appropriate for preventive care appointments.
Follow up with members if they miss their appointment and help them reschedule.
For members who need language assistance, let them know we offer help and information in their language at no cost. To speak to an interpreter, members may call the customer service number on their member ID card.
For STAR and CHIP members who have transportation barriers, let them know that we provide free non-emergency transportation services. Learn more about rides for STAR and CHIP members.
See our Health Equity and Social Determinants of Health page for more information on health equity.

For men who are at high risk, the American Cancer Society recommends discussing with them how to manage risks.

Resources

For Texas Medicaid Provider Quality Improvement, review the following resources ranging from quality measures data to current vaccine schedules:

The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.