Abstract P4-10-18: Medismart-Oncosmart: A low-cost private initiative to improve health care access in the middle-income country of Costa Rica. Overview of the breast cancer screening program

Abstract

Abstract Background: Costa Rica is a middle-income country in Central America with a public, government run, universal health care system which provides coverage to over 95% of the population. Despite being recognized as one of the best health care systems in Latin America, recent national reports suggest that up to 15% of the population is currently on a waiting list for a medical visit or procedure. The impact of the national breast cancer screening program is unknown as the country's health care system and the national cancer registry fail to report statistical variables like screening waiting lists, breast screening coverage, stage at diagnosis, time from screening to biopsy, breast cancer subtypes, breast cancer mortality by stage, among others. Methods: In 2014, the private health plan Medismart partnered with the private Hospital Metropolitano network with the mission of developing a low-cost health care system that provides efficient access and affordable health care services to its affiliates. Medismart's health care plan costs $12 a month per member ($6 per additional affiliated family member) and uses a copay model for health care services utilized by its beneficiaries. In 2016, Oncosmart, a program of Medismart, was developed with the goal of implementing population based screening, diagnostic procedures, cancer treatment, and survivorship care to its members. The program has no restrictions on pre-existing conditions. Results: From January 2015 to April 2017, Medismart subscribed 50,122 members. During the first 12 months of launching the breast screening program, 3634 women (32% of target population of 11058 women over 40 years old) underwent breast cancer screening mammography, breast ultrasound or both at the Hospital Metropolitano network. The copayment price of mammography screening for Medismart members is $26 and the copayment price for breast ultrasound screening is $38. Of the women who underwent screening in this period, 153 required a breast biopsy and all biopsies performed at the Metropolitano hospital were completed within 30 days from the abnormal imaging study. Conclusion: Medismart-Oncosmart is a low cost and efficient private initiative that improves access to breast cancer screening in Costa Rica. Citation Format: Wiernik A, Lami Casaus L, Durman M, Herrera Guido R. Medismart-Oncosmart: A low-cost private initiative to improve health care access in the middle-income country of Costa Rica. Overview of the breast cancer screening program [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-10-18.