Insurance is not enough for women at high risk of breast cancer, study finds

Apr 21, 2021 10:04 PM STI

Cleveland, Ohio) [US], April 21 (ANI): Women at high risk of breast cancer face barriers related to the cost of care, even when they have health insurance, according to a new study.
The results suggest the need for greater transparency in healthcare pricing and policies to remove financial barriers to early cancer detection.
The study by researchers at Ohio State University included in-depth interviews with 50 women – 30 white, 20 black – considered to be at high risk for breast cancer based on family history and other factors. It appears in the Journal of Genetic Counseling.
The researchers considered this given that women without insurance would face serious barriers to preventive care, including genetic counseling and testing, prophylactic mastectomy, and advanced breast imaging.
But they wanted to understand the nuances better – how finances played into decision-making in other ways and for women who had confidence.
“Financial barriers regularly appear to hinder access to critical information that high-risk women can only get through genetic counseling and testing, and prevent them from seeking regular screenings that could detect cancers in women. early stages and most treatable, ”said co-lead author. Tasleem Padamsee, assistant professor of health services management and policy at Ohio State.
“For women at the highest levels of risk, financial barriers can also put the most effective preventive surgeries and medications totally out of reach,” said Padamsee, who is also part of the Ohio State Comprehensive Cancer Center.
The study provided several new insights into barriers to care, including:

-Financial constraints do not only affect health care and preventive choices for low-income or uninsured women. Across the financial spectrum, women have reported worrying about the financial impacts of prevention choices and avoiding taking actions they cannot afford or are unsure if they can afford.
-When women decide whether or not they can afford a procedure or a test, they don’t just consider the expense of that specific care – they balance those costs with other financial demands they face, debt care for children and other illnesses they face. can pay for treatment or for a family member. Competing claims play a unique role in cancer prevention care, the authors said.
-Financial considerations are influenced by more than the financial realities of women’s lives. They are also influenced by broader social and political issues such as the lack of price transparency on the part of insurance companies, which often forces women to guess which services are covered and which are not.
“Underinsurance was a really important factor – even for women who have private insurance, they face many obstacles in seeking coverage for genetic testing, counseling, risk-reducing surgeries and improved breast screening.” , said Rachel, co-lead author of the study. J. Meadows, who worked on research as a doctoral student at the Ohio State College of Public Health.
“These women manage other priorities, particularly between paying for care for the chronic illnesses they currently suffer from and managing future risk. And they have other financial demands, including raising children and supporting other family members, ”said Meadows, who currently works at the JPS Health Network’s Outcome Research Center in Fort Worth, Texas.
Many high-risk women also worry about the risk of future discrimination if they undergo genetic testing, she said, although the current law prevents genetic discrimination.
Often, studies simply examine the association of income and insurance status with health service use, but the detailed conversations of this work with women can help advocates, providers and others better understand the intricacies of decision-making, the researchers said.
“All of this information is critical to our ability to improve care.” Knowing that a wide range of high-risk women are affected by financial constraints suggests that they might be best served by providers who are trained and willing to share information on insurance coverage and costs. and financial aid programs as well as information on potentially useful tests and procedures, ”said Padamsee.
The study results also suggest the need for regulatory changes such as long-term guarantees against genetic discrimination and stricter requirements for insurance companies to disclose all of their benefits and co-pay in a more transparent and understandable way. , she said. (ANI)