Expert: Reaching Out for Healthy Women, A Data-Driven Approach to Helping Women Access Health Care

Pharmacy Times interviewed Broc Pollinger, MSW, LSW, OSW-C, manager of patient support services at St. Luke’s University Health Network, St. Luke’s Cancer Center, on the impact of the Reaching Out for Healthy Women initiative. Pollinger describes how the initiative utilized data to determine the number of uninsured women within the service area who met the criteria for breast and cervical cancer screenings. He will discuss the initiative as well as its findings and significance on a panel during the Association of Community Cancer Centers National Oncology Conference.

Pharmacy Times: Can you provide an overview of the Reaching Out for Healthy Women initiative and explain why it is important?

Broc Pollinger: Reaching Out for Healthy Women is an outreach and screening program designed to connect unestablished patients and uninsured patients with care. Our team really outreaches the patient and provides education surrounding the importance of screening and the resources, on how to get screened, provides a coordination of care, and then helps provide access for those women health screening programs, so cervical and breast cancer screening.

The reason why the program is vital to the community is due to the ability for us to really leverage our electronic medical record and data monitoring to increase patient screening rates, primary care appointments, access to primary care, improving access to all care, and then in addition to that, increasing insurance rates.

Pharmacy Times: Were there any insights or findings that were particularly noteworthy?

Pollinger: So, one of the big things that we noticed was trust was a huge, huge barrier. A lot of patients don't necessarily trust the health care system when it comes to the financial side of things. They're worried that they're going to be receiving a large bill and surrounding good faith estimates—I'm sure a lot of health institutions are dealing with the same thing—but giving the no surprise billing or really providing that detailed information, patients get very worried when you let them know that they could be potentially responsible for a bill. That really scares off a lot of our patients even wanting to get treatment, so 1 of the things that we were able to do is really connect with these patients on a 1-to-1 basis, supporting them through that process, getting them connected with financial counseling, getting connected with our case management department.

We actually had a really great recent success story in which 2 uninsured patients—but 1 mainly—came in uninsured, didn't have primary care, really was unestablished, but we were able to get them access to both breast and cervical cancer screening. During that process, they connected with our financial counselors in our case management department, and they ended up getting medical assistance. During that process, they were able to get additional screening, which included access to a podiatrist—they received a bone density scan—and then the case management department we were able to get subsidized nutrition benefits for the patient and family. So, that was a really big win. That is why we are doing the program that whole start to finish really was the goal of this initiative.

Pharmacy Times: In what ways do your partnerships with representatives from hospital administration, rural health clinics, wellness centers, etc. support the initiative? How may they provide support in the future?

Pollinger: When I first started this program, it really started out as a grant-funded only program and what I noticed is that a lot of the time we would use utilize those grants, but the wraparound services was the hardest part. So, what we ended up doing is I went to all the hospital administration presidents within our network, and was able to obtain screening for 1000 patients, both for cervical and breast cancer screening. What this allowed us to do is really guarantee that support from them in regards to patients who met that criteria: uninsured and unestablished.

We also leverage the health clinics and wellness centers to essentially start that access point. So, we would refer them into these areas and that's where they would establish primary care, where they would have access to financial counseling and case management services. So, those are some really big key players and key supports that allowed us to start this program and get it moving.

So, what we're doing [with our partnerships] is we're in the midst of finalizing a contract with Adagio Health—which is a third-party medical management company—and they currently have the contract through the state for cervical and breast cancer early detection. So, we have signed contracts at this point to become a certified site, both at a St Luke's level and within the Star Community Health clinics. What we're going to be doing is rolling out this additional initiative to help patients who are uninsured or underinsured. This will allow access to these patients so they don't have any payment. So, what was once supported by our hospital administration will not need to be supported by the hospital administration, because we will be able to utilize this program through the state, and the state is supporting all of these patients.

Pharmacy Times: What would be some potential developments or innovations in patient support services at St. Luke’s Cancer Center and how may that build on the Reaching Out for Healthy Women initiative?

Pollinger: Like I spoke about earlier, the whole intent of this program, while the access point was cervical and breast cancer, it really is the focus of treating the whole person. So, the goal of this is really to transition into more of a health equity department. Right now, we have a certain amount of community health specialists that outreach patients, and those 2 individuals will continue to [do so], but the manner in which they're outreaching, and

The topics they're discussing is going to expand. Right now, it’s cervical and breast [cancers] and there's a lot of focus around trying to support the grant and an access to care. But with the state supporting that, it's going to take down a lot of barriers, which will allow us to spend additional time on additional screening—such as lung cancer screening—and helping patients understand the importance, provide education, and coordination of care. So, I think the movement of this will allow and free us up to expand and to create this health equity division.

Pharmacy Times: Are there plans to further expand outreach in the future and what might that look like?

Pollinger: The outreach is definitely [already] outside of the Cancer Center already. What we do is we're accessing patients who are unestablished, they only may have touched us in the ED, they may have touched us in a clinic or 1 of our emergent centers, so the goal is to continue to outreach these patients—underinsured, or uninsured, or unestablished—outreaching, providing education and support and we're going to continue to expand that. So, while we have 2 individuals now working roughly 15 hours per week, we're going to continue to look to expand that. So, absolutely.

Pharmacy Times: Final thoughts?

Pollinger: I think just re-highlighting the most important piece. We have this electronic medical record—a lot of institutions have electronic medical records—and I think really leveraging the data that you already have in more creative ways to try to support patients and identify them is where this really originated from. So, I just encourage institutions to continue to look into that and to continue to leverage what already exists in supporting our patients and our communities.