Transforming breast cancer care with personalized navigation.

As we recognize Breast Cancer Awareness Month this October, it’s important to shine a light not only on awareness and prevention but also on the challenges of navigating the healthcare system after a diagnosis. When faced with breast cancer, the road ahead can feel overwhelming, but with care navigation, patients can find the support they need to manage their treatment journey more confidently.

The importance of early detection.

Breast cancer is one of the most common cancers affecting women worldwide, with 1 in 8 women being diagnosed in their lifetime. Early detection through regular screenings—such as mammograms, clinical exams, and self-checks—has been proven to save lives. Yet, according to the 2023 Early Detection Survey, 10% of women aged 40 and older have never had a breast cancer screening, and one-third are not currently up to date with their screenings.

Challenges in navigating a diagnosis.

A breast cancer diagnosis thrusts patients into a maze of medical appointments, treatment options, and insurance considerations. It can be overwhelming trying to manage all the moving parts leaving them with questions like:

• Which specialists should I see?

• Which doctors are in-network?

• What treatment options are best for me?

• How do I manage the logistics of multiple appointments?

• What costs are covered by my insurance?

• How can I cope with the fear and anxiety from my diagnosis?

For many, these questions compound the emotional weight of a diagnosis. This is where healthcare navigation comes in—a system designed to guide patients through the medical, logistical, and emotional complexities of breast cancer care- whether it's for prevention or after a diagnosis.

How care navigation makes a difference.

Care navigation supports patients throughout their healthcare journey, from diagnosis through treatment and recovery. Health guides, who are nurses, social workers, or other healthcare professionals, act as healthcare advocates for each member, helping patients understand their care options and make informed decisions by:

1. Encouraging preventive care.

Health guides proactively identify patients who are behind on recommended screenings, such as mammograms, and help them schedule appointments. By facilitating timely preventive tests, care navigators ensure that potential issues are caught early, which is essential for improving outcomes in breast cancer treatment.

2. Connecting patients to high-value care.

Finding the right healthcare team is one of the first hurdles breast cancer patients face. Care navigators help identify high-value care that includes the best oncologists, surgeons, radiologists, and other specialists based on the patient’s specific diagnosis, location, preferences, and insurance coverage. 

3. Clarifying complex treatment options.

Breast cancer treatment is not one-size-fits-all. Depending on factors like the type of cancer, its stage, and the patient’s overall health, treatments may include surgery, chemotherapy, radiation, hormone therapy, or newer therapies like immunotherapy. Care navigators help patients understand what to expect during their journey and how to manage side effects.

4. Coordinating care.

Breast cancer treatment often involves multiple healthcare providers, including radiologists, oncologists, and surgeons. Healthcare navigators streamline the process by coordinating appointments, talking to doctors, and managing referrals. They can also help patients connect with cancer care point solutions available in their employee healthcare benefits. By handling the administrative side of care, navigators reduce the burden on patients and their families, allowing them to focus on healing rather than logistics.

5. Providing financial guidance.

Navigating the financial aspects of cancer care can be overwhelming. Care navigation solutions can offer billing specialists who assist patients in understanding their insurance coverage, calculating out-of-pocket expenses, adjusting incorrect bills, and identifying financial assistance programs if needed. 

6. Supporting emotional needs.

A breast cancer diagnosis can take a significant emotional and psychological toll on patients and their loved ones. Care navigators help by connecting patients with counseling services, support groups, and mental health professionals to address the emotional challenges of living with cancer. 

7. Offering ongoing support.

Support from healthcare navigators doesn’t end when active treatment concludes. Breast cancer survivors often need ongoing monitoring for recurrence, long-term management of side effects, and support for reintegrating into daily life. Care navigators assist with connecting survivors with resources that promote long-term well-being, such as rehabilitation services, lifestyle programs, and mental health support.

Take action this October.

Whether you're scheduling a mammogram for early detection or seeking resources for breast cancer support, every step counts. During Breast Cancer Awareness Month and beyond, taking proactive steps toward your health is crucial. 

At Rightway, we're here to help our members navigate their healthcare journey with confidence. Interested in learning more about how our clinical care navigation solution can support your team? Learn more here.