e23116 Background: Women with MBC experience unmet unique symptom management and psychosocial needs due to chronic treatment for an eventually life ending illness. Methods: The MBC Program of Care is a 1 hour weekly, nurse led review of scheduled clinic patients by an interdisciplinary team incorporating structured needs appraisal and referral for supportive, palliative care resources. Outcomes included referral rates to supportive services, patient reported outcomes (PRO) of symptom distress, generalized anxiety and overall well-being. Health care utilization outcomes included clinic calls as well as inpatient and emergency room visits. A prospective, paired pre and post experimental design. One hundred and eighteen women with MBC who visited an urban outpatient breast cancer clinic from September 2016-November 2016 (pre) and from January 2017-March 2017 (post). Validated instruments of symptoms ( Adapted Memorial Symptom Assessment), anxiety (Generalized Anxiety Scale), and overall well-being scores (0-10 Likert) assessed PROs. Electronic chart review evaluated social work and palliative care referrals, hospital admissions, emergency room visits and phone calls to the outpatient clinic pre and post program implementation. T test and chi squared test for paired comparison of mean was performed. Results: Following program implementation, referrals to palliative care (p = .000) and social work (p = .001) increased significantly. PROs of symptoms (p = .001); anxiety (p = 0.002); and overall well-being (p = .002) improved significantly. Health care utilization including emergency department visits (p = .001) and patient calls (p = .005) decreased significantly post program implementation, although hospital admissions increased (p = .003). Cost of program was $750 weekly. Conclusions: Systematic review of patient needs and referral to existing supportive services improved MBC PROs and decreased emergency room visits and clinic calls. Post hospital admission increase may be attributed to MBC disease progression. This is a cost effective MBC model of palliative care implementation.