The PCC is committed to improving the quality of care for low-income women across the continuum of breast health care. We apply our expertise in process improvement, data collection systems, and building relationships to improve the quality of care and reduce systemic barriers to care.

Breast cancer is the fifth leading cause of death among American women, and the most common cancer among women. While women from any background may be diagnosed with cancer, disparities in cancer screening and treatment affect women from ethnic minorities and with low incomes. Research from the American Cancer Society shows that low-income populations receive fewer preventive services and poorer quality of care.

• Low-income and uninsured women are less likely to receive timely screening mammograms than women with health insurance
• Women who are uninsured or on Medicaid are 2.5 times more likely to be diagnosed with later stage breast cancer (Stage III or IV) than privately insured women
  
• Racial and ethnic minorities are more likely to receive inappropriate treatment for breast cancer than white patients, have poorer satisfaction with the quality of their care, and face a higher mortality rate
  

Beginning in 2007, the PCC and our partners have worked to address process challenges and supply shortfalls to improve breast cancer screening rates among low-income and uninsured women. We have also decreased disparities in breast health care.

Through interviews with primary care providers serving uninsured women, the PCC realized that providers were reluctant to refer women for recommended screenings if they knew the woman could not afford the service. With this in mind, the PCC worked to improve referral processes at clinics and conducted advocacy efforts with radiology providers and local governments to secure low-cost mammograms for vulnerable women.

In 2007, working with safety net clinics and mammography providers to streamline the referral process, we increased screening rates at the participating clinics for women in the recommended age group from 5.2 percent to 39.3 percent. In 2010, we expanded the project to include safety-net clinics in Prince George’s County, the District of Columbia, and Northern Virginia. By 2013, we had seen significant improvements in referrals, screening rates, and time from referral to screening at nine clinics across the region.

Program efforts resulted in improved services for patients through increased awareness and timely access to breast health services, efficiencies for clinics through new and enhanced collaborative partnerships, and streamlined processes for breast health including improved clinic charting and coordination of care within the clinic.
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At the same time as addressing process challenges, PCC began to advocate with funders, local government, and radiology providers to secure a supply of affordable mammograms for low-income women. Through this collaborative effort, we have built an infrastructure to support cancer screening so that every low-income, uninsured woman can be referred and obtain a mammogram with as few barriers as possible.