Equal Hope's Medicaid breast cancer coordination of care improvement initiative.

Abstract

e13518 Background: In 2022, there were 11,000 breast cancer diagnoses and 1,600 deaths due to breast cancer in Illinois. Chicago women reporting a mammogram in the past two years was 74.9% however this might be inflated due to self-report data. Studies show that the rate is even lower among individuals with Medicaid or no insurance. Equal Hope is a community-based organization dedicated to eliminating health inequities in the Chicagoland area. The purpose of this initiative was to increase breast cancer screening utilization among Chicago women with Medicaid utilizing Equal Hope’s decentralized patient navigation model. Methods: Five Illinois Medicaid managed care organizations (MCOs) participated in the initiative and sent information for female clients ages 40-64 who did not complete a screening mammogram within the past two years and lived in a west or south side Chicago zip code. By December 2025, a total of 20,494 clients were eligible to participate in the project. Six Equal Hope navigators conducted at least three attempts and assisted in scheduling a mammogram. This is an ongoing project, and this analysis was restricted to clients who received at least one attempt resulting in a final sample size of 14,148. Client demographic and zip code level characteristics were used to describe client outcomes. Results: From February to December 2025, navigators made over 29,000 attempts for 14,148 clients. After excluding 28% of clients due to incorrect contact information, 6,345 were considered unreached, 1,645 reached, 1,423 refused, and 846 enrolled. Clients’ Medicaid MCO, race and ethnicity, and zip code characteristics such as the number of mammography sites, social vulnerability index (SVI), avoidable ED visit rate, rent and transportation burdened, and walkability index showed significant differences in program outcome. MCO D represented the largest enrolled in the initiative (8.8%), MCO C the largest unreached (71.3%), and MCO B the largest refused (20.1%). Clients who lived in a zip code with at least 3 mammography sites (11.0%) had the largest group enrolled. By December, 638 mammograms or ultrasounds were scheduled. Conclusions: Overall, this initiative has proved to be effective in reaching the Medicaid population in Chicago. The primary challenge has been a lack of valid contact information for clients. Regardless, Equal Hope is currently evaluating novel methods to increase collaboration between local clinics to ensure that all individuals have access to quality mammography screening.