How a Texas Nonprofit Built a Model for Accessible and Equitable Healthcare
HOUSTON (September 14, 2020) – The keys to saving the life of a woman with breast cancer are screening and an early diagnosis, but in the United States, many women die of breast cancer because the costs of these procedures are a barrier for them. This is compounded if they are uninsured. In addition, fear of contracting Covid-19 has made women more reluctant to schedule and keep medical appointments. Founded in 1986, The Rose, a southeast Texas nonprofit organization, offers premium breast health prevention, diagnosis and treatment to 40,000 patients in over 40 counties annually, regardless of their ability to pay. They do this through their Empower Her® Program, a unique and replicable approach to breast health provides comprehensive breast health services as well as ongoing support for patients in treatment.
At The Rose, accredited as a Breast Imaging Center of Excellence, every service offered is available to uninsured patients including mammograms, ultrasounds, diagnostic work-ups, physician consults and biopsies. Such costly and sophisticated imaging services are usually out of reach, financially, for the uninsured. The uninsured remain most at risk of dying from breast cancer detected at later stages.
By leveraging revenue obtained from insured patients, The Rose applies a 3-to-1 model to provide services to the uninsured. Three insured women cover the costs of a screening mammogram for one uninsured woman—the first step in breast healthcare. Grants and individual gifts are applied to the cost of diagnostic evaluations for symptomatic patients and follow-up for abnormal screening mammograms. The combination of leveraging revenue with philanthropic funding creates an efficient way to serve a large uninsured population and also ensures a continuum of care.
Once an uninsured patient is diagnosed, the next challenge is securing treatment. The Rose’s Patient Navigation Program, initiated in 1999, has moved thousands of uninsured women into treatment. Patient Navigators are with the patient when she hears the words “you have breast cancer” and continues to be by her side until treatment is finished.
Both the 3-to-1 model and the Patient Navigation Program are replicable and offer a non-government funded option to caring for the uninsured.
The American Cancer Society estimates that a quarter of a million women will be diagnosed with breast cancer this year. While early detection is the best way to save lives, a recent white paper found routine screening appointments were down between 86-94 percent in March. The fear of COVID-19, coupled with historic job losses, indicates that women may be reluctant to keep an appointment or may have lost health insurance when they lost their jobs. An estimated 1.6 million Texans lost employer-sponsored health insurance this spring, according to the Kaiser Family Foundation. While legislation could eventually reduce or remove the costs of screenings for women and provide broader access to health insurance, The Rose knows that many women cannot wait.
“My mother died of metastatic cancer in a charity hospital when I was 20 years old,” Dorothy Gibbons, CEO and Co-Founder of The Rose shares. “She knew something was wrong, but working part-time meant no health coverage. By the time her cancer was detected, it was too advanced for any treatment. I remember holding her hand as she took her last breath and wondering what would have been different for her if she had had insurance. The ultimate impact of poverty has stuck with me forever, and over the years, I’ve seen way too many women die because access to health care for the uninsured does not exist.”
The Rose’s approach to care has inspired providers in other states (including the Breast Care for Washington DC) to duplicate their Empower Her® Program in an effort to break down barriers to screening and treatment and make survival possible. Serving nearly 40,000 women annually in over 40 counties in Texas, The Rose’s successful specialty care model offers access to premium breast health care for all patients regardless of their income, insurance status, or ability to pay.
About The Rose
As a Breast Imaging Center of Excellence, The Rose is one of only 14 Breast Centers in the greater Houston area to receive this designation. Led by Fellowship trained physicians, The Rose’s advanced digital technology includes 3-D tomosynthesis mammography, diagnostic work-ups including biopsies and its nationally recognized Patient Navigation Program ensures access to treatment and a continuum of care for all women. Since 1986, The Rose has led strong advocacy efforts for quality breast healthcare, and been on the forefront of innovation in breast healthcare. As a major specialty care provider within the Healthcare Safety Net system, The Rose is considered to be a leading nonprofit in breast healthcare. Annually, The Rose serves 40,000 insured and uninsured women and men. With two Houston-based comprehensive Breast Diagnostic Centers and a Mobile Mammography Health Program, The Rose provides services to women throughout 41 counties in Southeast Texas.