ACOs Using Lightbeam Solutions Achieve $3 Billion+ in MSSP Savings. Read the press release to learn more.

Breast Cancer

Integrating Breast Cancer Detection with Value-Based Care: An Interview with Lightbeam’s Jessica Scruton

Share This

Breast Cancer Awareness Month is well underway, and today we are discussing the integration of preventative measures with value-based care strategies to proactively treat patients and maintain cost-conscious practices.

Our in-house Clinical Transformation Advisor, Jessica Scruton, BSN, RN, CCM, took the time to discuss both of these topics in honor of this initiative. Jessica has been in the healthcare space for over 20 years, and before joining Lightbeam, she served as a Senior Director of Clinical Advisory at her previous healthcare company. During her time as a nurse, she served in the intensive care unit (ICU), where she realized she wanted to pursue further certifications in care management. Her aunt is currently battling breast cancer, and she believes in taking every opportunity to discuss both prevention and early detection.

Jessica, what are some important things to know about breast cancer and early detection?

Breast cancer can present itself in one of four stages. When breast cancer is detected early and is in the localized stage (zero to one), the five-year relative survival rate is 100%. 62% of breast cancer diagnoses are at this stage. Ways to promote early detection include performing breast self-exams monthly, scheduling regular clinical breast exams, and mammograms. Any abnormalities in the look or feel of the breast, such as pain, size, texture, or temperature should send a patient to the doctor for examination. Lumps in the breasts or underarms or swelling in either of these areas warrant immediate attention, too, as swelling is indicative that it may have spread to the lymph nodes.

Some additional symptoms and signs can be found here.

Are there ways to prevent breast cancer?

As with other cancer forms, we have a limited understanding of what causes breast cancer and the mutation of DNA. There are always lifestyle changes that can lessen the risk of developing the disease, like regular exercise, consuming alcohol in moderation, maintaining a healthy diet and weight, and not smoking. What I always like to cover are risk factors like age, family history, menstrual and reproductive history, and other predispositions that cannot be changed. I encourage everyone to research their background; knowledge and preparedness are essential.

What is a breast cancer initiative that value-based care can achieve?

Both patients and payers are affected by the staggering costs of cancer treatment. Earlier detection of breast cancer by routine screenings leads not only to lower mortality but also helps reduce the costs of treatment. Advanced cancer treatment often surpasses a patient’s insurance limits. From a population health perspective, the return on investment (ROI) for screenings is not a short-term financial gain, but the sooner the cancer is found, the better the circumstances are for both the beneficiary and provider. That is a very non-emotional answer, I realize; cancer changes everything for an individual and their family. Care management initiatives are rarely “cookie-cutter” because we tailor them to the population at hand, and at Lightbeam, we are not afraid to be innovative.

What are common barriers that prevent patients from taking preventative steps, like getting mammograms?

What I believe are the common barriers to patients taking preventative steps are a lack of breast cancer knowledge, belief in the various myths out there regarding the disease, limited resources, either geographically or based on the patient’s means, poor access to care, or care that is poorly coordinated.

What can Lightbeam clients do to be more proactive in breast cancer detection?

During this month, and every month really, clients should leverage the Lightbeam platform‘s insights whenever they can. Data is power! Targeting specific populations and using the information to identify who is noncompliant is a great first step. A “best practice” suggestion for breast cancer detection is finding the percentage of women between 51 to 74 years of age who have not had a mammogram this year. They should become a care team’s priority for outreach. Clients should also use care management documentation to track their population’s trends for care barriers, as social determinants of health (SDoH) factors always differ. The next step is to solve those barriers creatively, like in our work with Mohawk Industries. It pays off for both the patient and in the organization’s reimbursement down the road.

Throughout the rest of October and beyond, we at Lightbeam encourage everyone to take the proper measures when it comes to breast cancer prevention and early detection. For additional breast cancer resources, visit:

National Breast Cancer Foundation, Inc.

American Cancer Society

Lightbeam’s Clinical Transformation Advisor, Jessica Scruton, BSN, RN, CCM.

John Henson, a Marketing Associate at Lightbeam.

Share This