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Member News -- WANTED: Five Thousand Horizon BCBSN..

Breast cancer experts offer differing advice when it comes to when and how often a woman should get a mammogram and that conflicting advice has created confusion that could have an impact on treatment. Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) is addressing this problem by covering the cost for 5,000 of its members to participate in a five-year study intended to improve screening guidelines. The Women Informed to Screen Depending OMeasures of Risk (WISDOM) Study seeks to clarify which method is safer and more effective for women: routine yearly screening or a personalized screening schedule that takes into consideration genetic and other personal factors like age, family history, and breast density.

“Working with the Athena Breast Health Network to identify a more personalized approach to breast cancer screening helps further Horizon’s goal of connecting members with the right care, in the right setting, at the right time,” said Horizon CEO Kevin Conlin. “By supporting the development of better screening guidelines, we can give our physician partners a better tool to help their patients, help women avoid unnecessary tests and procedures, and lower the total cost of care for our members.”

“Horizon has, for many years, invested significant money and resources to support the development of evidence-based diagnostic and treatment protocols through clinical-trials and other forms of research like the WISDOM Study. The pace at which scientists and doctors are producing new approaches and therapies has been accelerating over the past few years. Horizon constantly updates our medical policies to reflect the latest evidence-based recommendations produced by this research so that our members can benefit from new and life-saving medical breakthroughs,” added Allen Karp, Horizon’s Executive Vice President for Health Care and Transformation Management.

“Breast cancer is the second leading cancer-related cause of death in New Jersey and early detection is the key to successful treatment, yet the most recent data shows that 1 in 5 women age 50-74 living here did not have a mammogram. Improving breast cancer screening protocols can help us close that gap in care and focus on reaching women with a higher risk profile,” added Vice President and Chief Medical Officer Thomas Graf.

Funded with support from the Patient-Centered Outcomes Research Institute and the Robert Wood Johnson Foundation, the Study is being conducted by The Athena Breast Health Network (Athena) – a group of breast cancer experts, health care providers, researchers, and patient advocates at five University of California Medical Centers.

WHO IS ELIGIBLE

Horizon BCBSNJ members between the ages of 40 and 74 years who have not had a mastectomy, breast cancer or ductal carcinoma in situ (DCIS) are eligible to participate. Interested members can learn more about the WISDOM Study and sign up to participate by visiting www.wisdomstudy.orgwww.wisdomstudy.org opens a dialog window.

HOW IT WORKS

Eligible members who choose to participate will be randomly assigned to either a personalized screening schedule or an annual screening schedule. If a woman prefers to choose her own screening schedule, she can do so and decide to be in either the personalized or annual screening group. All enrollees are asked to commit to participate for the full, five-year duration of the study.

Members in the personalized screening group will be asked to submit saliva samples for genetic testing of 9 genes associated with increased breast cancer risk. A genetic testing kit will be mailed to the participant’s home address and the kit will be returned by mail. The results from the genetic test and other risk factors like family history, breast density, and previous breast biopsies will be used to determine a woman’s risk for breast cancer according to the Breast Cancer Surveillance Consortium (BCSC) model. Their risk results will then shape their screening schedule.

Women in the annual screening group will not receive genetic testing, but will simply get one mammogram a year, beginning at age 40.

Participants in both groups can have their screenings done locally at any of the facilities that participate in Horizon BCBSNJ’s network. There are no new or additional costs for members who choose to participate in the Study. Participating members will be asked by the Study to complete annual follow-up surveys in about changes in their breast health. Study participants will access their information through a secure, dedicated portal and the study complies with HIPAA privacy guidelines.

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