Generating Revenue from Your High Risk Program

Mar 3, 2020

Last month, we shared a story about how one of our clients (CHRISTUS Ochsner Lake Area Hospital’s Wellness, Screening, and Genetics Center) is using CancerIQ within their high-risk program.

The focus was on how Leah Marcantel, Nurse Navigator, uses our software to manage a high volume of patients, stay on top of her patient follow-ups, and create proactive prevention plans. 

Since its publication, we've received requests wanting to learn more about the downstream revenue impact. Especially as people head into budget conversations with hospital leadership.

So, today we’ll dive deeper into the stats over at CHRISTUS and show how a high-risk program can positively impact the overall bottom line at your hospital. We’ll also share an exciting story about a patient who was referred to have an MRI and how the MRI caught a small mass that was previously missed on her mammogram.

Main Source of Downstream Revenue: Increased MRIs

Before CancerIQ, CHRISTUS was not doing any MRI referrals.

In the five months since implementing CancerIQ, CHRISTUS referred 310 women to an MRI, averaging around 2 or 3 MRIs a day.

“It’s been a lot easier to track my numbers with CancerIQ. In five months, what we’ve generated, potentially, is just under $155,000 by adding these additional high-risk screenings for patients who would otherwise just be coming in for mammograms and going home.”

More statistics:

  • Leah has tested and received results from 670 patients
  • 14% who received testing came back as high-risk negative. (94 women).
  • 11% mutation positive. Most of those were related to breast cancer.

Other Sources of Downstream Revenue

The main source of downstream revenue are the MRI tests, but there’s also an impact with colonoscopies and dermatology referrals.

“We try to keep it all within our system. So, with these specialist visits, we’re adding to the volume of their patients.”

With the success of her program, Leah is starting to receive more outside referrals. This has led to screening more patients, increasing the number of initial mammograms and MRIs.

Another source of downstream revenue is surgery. Two of Leah’s patients were referred for mastectomies within the health system and five patients with BRCA1 or BRCA2 positive mutations were referred to discuss prophylactic surgery. The prophylactic surgeries, however, were outside the facility, about an hour away.

Patient Success Story

In the last few months, there have been four cases where a mass that didn’t appear on the mammogram was then identified in an MRI.

One patient, who was initially seen at a different facility, went through the CancerIQ questionnaire and was flagged as high-risk. She proceeded to have genetic testing ordered via Myriad and found out she was BRCA2 positive. Leah referred her to have an MRI which then identified a mass that was too small and too close to the chest wall to be picked up in her initial mammogram.

“Had she waited next year for her mammogram, it would have been a much different situation. We’ve definitely seen more getting caught with MRI and typically much earlier rather than waiting until their next mammogram. We’re seeing the benefit of doing these high-risk MRIs, it’s not just one more thing for patients to do.”

Leah attributes the CancerIQ questionnaire as a crucial part of the process identifying high-risk patients.

“Before CancerIQ, we had a little tablet that asked a few of the main red flag questions. The CancerIQ questionnaire is more in-depth, does a thorough job of asking family history questions. Finds out which family members had which type of cancer and at what age.”

In conclusion

Our mission at CancerIQ has always been to put patients and providers first. The CHRISTUS story is one of many client success stories where what is good for the patient - in terms of catching cancer early, identifying high-risk patients, and setting up more tailored prevention plans - is also good for the downstream revenue at the hospital via MRIs, colonoscopies, and surgeries.

As you head into budget conversations with your leadership team, let’s connect in advance so we can equip you with more stories and statistics from our clients. These will build a compelling case for the downstream revenue impact and help secure budget for your high-risk program.

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