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What a colleague's breast health care experience taught us about genetic counseling

February 26, 2018

    In a recent conversation with one of our Advisory Board colleagues, we were struck by how pivotal cancer genetic counseling services were in her decision of where to receive her breast health care. Our members frequently ask about the best ways to demonstrate the ROI for this poorly reimbursed service, so we want to share her story and explain how it should change your breast cancer program's strategy.


    Convenience initially was the deciding factor in where to go for breast health care

    As an Ashkenazi Jewish woman whose maternal grandmother died of breast cancer in her mid-thirties, Brenda began receiving mammograms at age 35. Of the two community hospitals within 30 minutes of her house, Brenda initially did what many patients in her shoes would do and chose to get her mammograms at the slightly closer option: Jones Hospital (pseudonym). When the mammograms revealed that she had extremely dense breasts in addition to her other risk factors, she began looking into high-risk breast services, such as cancer genetic counseling.

    Availability of genetic counseling services outweighed convenience

    Because Brenda had never heard about genetic counseling services being offered at Jones Hospital, her first thought was to ask friends for recommendations. She was eventually referred to a cancer genetic counseling program at Smith Hospital (pseudonym)—the other hospital in her community. Although this hospital is 15 minutes farther from her house than Jones, she followed up on the referral.  

    After the initial consult with the genetic counselor in 2012, Brenda decided to move all of her breast health care to this hospital. To this day, she still receives all of her breast health care there (even though she and her family receive other health services at Jones). Over the years, Brenda has received breast MRIs, a breast biopsy, annual breast exams, mammograms, ultrasounds, tomosynthesis, and a BRCA test. We estimate that this amounts to almost $6,500 in reimbursement (based on Medicare rates)—and that adds up across multiple patients. Brenda told us that she never even considered switching her breast health care back to her original hospital.

    Market genetic counseling services if you have them, consider investing if you don't

    Our biggest takeaway? If your program offers cancer genetic counseling services, let patients and referring providers know about them. Had Brenda's original hospital done a better job of marketing its cancer genetic counseling services, which they do offer, she likely wouldn't have felt the need to turn to friends for guidance and leave the system. Not only did the original health system lose out on the opportunity to provide Brenda's breast health care, but they also lost out on being Brenda's go-to-provider for emergency care for her kids. After noticing Smith's newly built children's hospital during one of her breast health visits, she began to list that hospital as the one where she'd want her kids taken in an emergency.

    Learn tactics to attract new patients and improve your program's online presence

    If your program doesn't currently offer cancer genetic counseling services, consider making the investment. These programs serve a pool of patients who typically have an increased risk of cancer. By offering genetic counseling and testing services to these patients, your program is well-positioned to secure their loyalty and downstream service utilization—whether or not they are diagnosed with cancer. Furthermore, genetic counseling aids in the early detection and prevention of cancer—a goal every organization can support.


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