In Alabama, 23.2 per 100,000 women died from breast cancer...

October is Breast Cancer Awareness Month
ilated Eye Exam Initiative
The Health Care Financing Administration (HCFA), the American Academy of Ophthalmology (AAO), and the American Optometric Association (AOA) have launched a cooperative
initiative to increase the dilated eye exam rate among Medicare beneficiaries with diabetes.
The AAO and AOA will match patients with diabetes with an eye professional in their area
who has agreed to perform a dilated eye exam and to provide or arrange subsequent care, at
no cost to the beneficiary.
Approximately 10,000 Alabama Medicare beneficiaries with diabetes have not had a dilated
eye exam in at least 3 years.
The initiative will include:
In Alabama, 23.2 per 100,000 women died from breast cancer during 1992-1996. Approximately 50% of the
female Medicare beneficiaries over the age of 50 in the state of Alabama did not have a mammogram in 1997 and
1998 even though Medicare Part B pays for 80% of the cost of a screening mammogram. Medicare pays
this even if the beneficiary has not reached the annual deductible.
Excluding cancers of the skin, breast cancer is the most common cancer among women, accounting for nearly one of
every three cancers diagnosed in United States women. In 1999, approximately 175,000 new cases of invasive
breast cancer will be diagnosed among women, as will nearly 40,000 additional cases of in situ breast cancer 1. In
1999, 43,300 women are expected to die from this disease. Only lung cancer accounts for more cancer deaths in
Continue annual mammograms in all your elderly female patients!
Breast cancer incidence and mortality increase as the population ages. Seventy-seven
percent of new cases and 84% of breast cancer deaths occur in women aged 50 and older.
For all races combined, women aged 20-24 have an age-specific incidence rate* of only
1.3 cases per 100,000; women aged 75-79 have the highest incidence rate, 483.3 cases
per 100,000.
A thirty second (: 30) television public service announcement featuring Bill Cosby
which has been mailed to 24 stations in the state. Mr. Cosby urges seniors with
diabetes to get an annual dilated eye exam, then directs viewers to call the AAO or
AOA national help-line at 1-800-222-3937, or 1-800-262-3947. Medicare beneficiaries with diabetes will receive a brochure the end of October 2000, and a second
mailing of the same brochure, 3 weeks later. The brochure states, “If you have
diabetes you are at risk for eye problems, including blindness, and may need treatment even if your vision is normal”. The AAO and AOA eye exam programs are
explained and the beneficiary is told to contact one of the toll-free numbers and to
get a dilated eye exam. The AAO and AOA toll-free numbers are printed on the
Press Releases which have been mailed to 156 media outlets throughout the state.
The article briefly explains the eye initiative and lists the AAO and AOA toll-free
Radio public service announcements featuring Alabama native, Nell Carter. Ms.
Carter speaks as a patient with diabetes and the importance of management and
prevention. The radio announcements will be distributed to radio stations throughout
the state in November.
Please help us make this initiative a success. As your patients with diabetes come
into your offices, ask them the date of their last dilated eye exam. If your patients
do not remember, please schedule their appointments with an eye professional
before the patients leave your office. The Diabetes Eye Assessment Form can be
found at (please go to Medicare-HCQIP Projects-Diabetes to print
the PDF file). It will also be mailed to you in the near future with instructions for its
use. Feel free to make copies of the form. The eye professional is to send your
office a copy of the results of the eye exam for you to place in the patient’s medical
On the Road...
Don’t forget your African-American patients!
For all ages combined, Caucasian women are more likely to
develop breast cancer than African-American women.
However, African-American women under the age of 50
have higher incidence rates than Caucasian women. In
Alabama, there is an 11% disparity rate in the mammography utilization rates between African-American and Caucasian Medicare beneficiaries.
1. Perform an annual clinical breast
exam on all of your female
patients over 40.
2. Discuss the advantages of early
detection by mammography.
3. Make the mammogram appointment for your female patients.
Together, we can make a difference!
Roberta Ford will do what
she can to make sure she
is around to enjoy her
grandson Tevyn by getting
her annual mammogram
Medicare covers an annual
screening once every 12
Cover Photo:
Roberta Ford with her three grandsons,
Mychal, Trynton and Tevyn Richardson
at Murphree’s Fruits and Vegetables.
This material was prepared by Alabama Quality Assurance Foundation under a contract with the
Health Care Financing Administration. Contents do not necessarily represent Health Care
Financing Administration policy. 6SOW-AL-OUPT-00-09 / qp1000.pm6
Many of you know that Medicare,
through the Health Care Financing
Administration (HCFA), is covering
more preventive care services than in the
past. We want to help you educate your
patients on what preventive services they
need and what Medicare covers. In our
continuing effort to meet as many of
Alabama’s physician office staff as
possible, AQAF is partnering with Blue
Cross/Blue Shield of Alabama Physician
Network Representatives. An AQAF
project manager will be making a brief
presentation on AQAF, what services
we offer, and available patient education
materials. The BC/BS network representative in your area will be contacting
you with dates and times of the meetings. We look forward to talking with
each of you this fall.
Ideas You Can Use to Improve Care
We would like to thank our new outpatient project study group. These enthusiastic physicians, nurses
and pharmacists met on August 22, 2000 to address the challenge of improving outpatient medical care
for breast cancer, diabetes and immunizations in the state of Alabama.
Alabama Quality Assurance Foundation / One Perimeter Park South, Suite 200 North / Birmingham, Alabama 35243-2354
Ideas generated from the diabetes group:
October 2000
Provide standing orders and protocols for the patient with diabetes regarding HbA1c and lipids.
Share the diabetes eye initiative.
Share the Diabetes Eye Assessment Form.
Use the eye intervention poster.
Ideas generated from the breast cancer/disparity group:
Continued from previous page
We continue to invite all health care providers to become
involved in these important projects and appreciate any
comments or advice which may facilitate overall improvement of the quality of care for Medicare beneficiaries in the
state of Alabama.
Advertise and support the use of mobile units in areas where mammography services are not available.
Use “tool boxes” that would include information on recommended
screenings, billing/coverage information and liability information.
Inform beneficiaries on Medicare coverage of screening vs. diagnostic
mammograms as well as other services covered by Medicare.
Use reminder stickers on the medical record.
*AQAF has the following items
available upon request:
Ideas generated from the immunization group:
Give influenza and pneumococcal vaccines.
Wear “Have you been vaccinated?” reminder stickers.
Offer CEUs/CMEs for educational inservices.
AQAF Inpatient Indicator Poster (1.00 each after first 25)
continued on back page
AQAF Outpatient Indicator Poster (1.00 each after first 25)
AQAF Diabetes Poster ($1.00 each after first 25)
AQAF Care for the Patient with Diabetes Brochures
• Introduction to Diabetes: What Medicare Pays ($.25 each after first 25)
• Blood Pressure Medication/Immunizations ($.25 each after first 25)
*Please fax or e-mail your request for an order form to 9701624 or [email protected]
with your name and address. The
order form can also be found at under HCQIP Projects.
• Fasting Blood Sugar/ Serum Creatinine/Lipids ($.25 each after first 25)
• Hemoglobin A1c ($.25 each after first 25)
• Foot Care/Exercise/Diet ($.25 each after first 25)
Breast Cancer
Awareness Month
Diabetes Eye Assessment Form
Now Available
Compliments to this Dynamic
Outpatient Committee
David S. Bell, MD
Michael Collins, MD
Harold Cox, MD
Greer Geiger, MD
Ghayas Habach, MD
Jack Hataway, MD
Saunders Hupp, MD
William Peinhardt, MD
Robert Sherrill, MD
Thomas Stokes, MD
Sarah Franklin, CRNP
Danny Johnson RPh
Jon Tanja, RPh
Patsy Kanter, RN
Lisa Miller, RN
NCI Mammogram Bookmark (S&H only after first 25)
NCI Mammogram Booklet (S&H only after first 25)
• Diabetic Eye Disease ($.25 each after first 25)
NCI Pap Test Booklet (S&H only after first 25)
AQAF Pneumonia Shot Brochure (S&H only after first 25)
NCI Mammogram Poster (S&H only after first 25)
HCFA Mammogram Bookmark (S&H only after first 25)
HCFA Mammogram Reminder Postcard (S&H only after first 25)
Diabetes Standards of Care (Hard copy, No Charge, you make
AQAF Mammogram Brochure ($.25 each after first 25)
Tear off pad of Diabetes Continuing Care Standards ($1.00 ea
or you may copy)
Coming Soon:
Watch your mailbox for the new Diabetes Eye Assessment
Form with instructions from Alabama Quality Assurance
Foundation, Alabama Academy of Ophthalmology and
Alabama Association of Optometry.
Alabama Quality Assurance Foundation