News from the Wisconsin Cancer Collaborative | February 2022
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This National Cancer Prevention Month, let's help reverse some of the pandemic's toll |
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The COVID-19 pandemic has had a profound impact on health behaviors that can increase cancer risk -- for example, alcohol and tobacco use have risen, and in some populations physical activity has declined.
February is National Cancer Prevention Month. We can use this month to promote health behaviors that reduce cancer risk and prevent disease.
In Wisconsin, we can dramatically reduce cancer risk by helping our patients and communities:
- decrease tobacco use and exposure.
- decrease excessive alcohol consumption.
- increase physical activity and healthy eating.
- increase protection from sun and UV exposure.
- increase HPV and Hepatitis B vaccination.
- reduce exposure to radon in homes, schools, and other buildings.
The Wisconsin Cancer Collaborative offers a wide range of tools to help support your cancer prevention work. For example:
How-to sheets for patients: These health literacy tools answer common patient questions about cancer prevention, screening eligibility, and insurance coverage. (Available in Spanish and English.)
Alcohol and cancer tools: Alcohol use can cause at least seven types of cancer. Wisconsin has the highest rates of heavy drinking and binge drinking in the nation. Use these resources to raise awareness about the alcohol-and-cancer connection.
HPV vaccine and cancer tools: The HPV vaccine can prevent at least six types of cancer. Unfortunately most Wisconsin youth are not getting vaccinated. Use these tools to enhance your efforts to promote HPV vaccination.
Sun safety social media graphics: As the weather warms, more people will be spending time outside. Use these social media graphics and sample messages to promote sun safety and reduce skin cancer risk.
County Cancer Data Dashboard: What are the most common cancer risk factors in your county? Explore cancer risk factors, screening rates, and other county-level data in our interactive data dashboard.
Resource Center: See our growing list of internal and external resources in our searchable online Resource Center. (To submit a resource for consideration, please email Alex Faust.)
Wisconsin Cancer Plan 2020-2030: Make sure your cancer prevention work is backed by the latest recommendations. Our state's Cancer Plan offers best practices, action steps, and data measures to help you create, implement, and assess evidence-based risk reduction progr ams.
Personal health behaviors are strongly influenced by the environments in which we live, work, learn, and play. Together, we can reduce cancer risk and prevent cancer death by ensuring that every community has the resources they need to support lasting health improvements for everyone.
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Helping people reduce their risk of cancer is an important part of the Wisconsin Cancer Plan 2020-2030. |
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Follow-up colonoscopies soon will be fully covered by most insurers |
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New guidance from the federal government will require most private health insurers to cover follow-up colonoscopies, without patient cost-sharing, after a positive non-invasive screening test.
When a patient receives an abnormal result from a stool-based screening or direct visualization test, they often need a follow-up colonoscopy to confirm a cancer diagnosis. Because follow-up colonoscopies often are considered diagnostic, they haven’t been fully covered by many insurers, leaving some patients with high out-of-pocket costs.
Now, under the new federal guidance (pages 10-12 in the link), follow-up colonoscopies will be considered part of a patient’s initial cancer screening, which means most insurers will be required to cover the cost in full.
The new guidance was released last month by the US Departments of Labor, Health and Human Services, and Treasury, as part of a larger set of updates to the Affordable Care Act related to health insurance coverage of preventive health services.
The new guidance is based on an updated recommendation from the United States Preventive Services Task Force last year, lowering the age for most colorectal cancer screenings to 45 years. When a stool-based test or direct visualization screening reveals abnormal results, the USPSTF recommends a follow-up colonoscopy for further evaluation.
After May 31, insurers will be required to comply with the new guidance when their new “plan year” begins. The guidance does not apply to Medicare beneficiaries, and it is unknown at this time if follow-up colonoscopies will be covered under Wisconsin’s Medicaid program.
Related Resource:
Help patients understand their screening options with our colorectal cancer fact sheet, available in Spanish and in English.
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Increasing access to recommended cancer screenings is an important part of the Wisconsin Cancer Plan 2020-2030. |
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No more surprise billing: new law protects against out-of-network costs |
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Surprise billing can occur when a patient receives care at an in-network facility, but from an out-of-network provider. For example, a patient undergoing surgery at an in-network hospital may unknowingly be treated by an out-of-network anesthesiologist. This can leave patients with unexpected medical bills, because insurers pay less for services from out-of-network providers.
Surprise billing is a form of balance billing, when a health care provider bills a patient for the remainder of the balance after health insurance has paid its share.
The No Surprises Act went into effect Jan. 1. It bans surprise billing and out-of-network charges for most emergency services, including emergency care that happens out of network or without prior approval.
The new law also bans out-of-network charges and balance bills for certain services, like anesthesiology, from out-of-network providers that occur as part of a patient’s visit to an in-network facility.
The new law does allow providers to ask patients to sign a waiver granting out-of-network charges in certain non-emergency circumstances. In the absence of a waiver, providers may be allowed to refuse care.
Some health insurance programs, such as Medicare, Medicaid, Indian Health Services, Veterans Affairs Health Care, and TRICARE, already had surprise billing protections in place and are exempt from the new law.
According to the Kaiser Family Foundation, the federal government estimates the new law will apply to about 10 million out-of-network surprise medical bills each year.
Related Resource:
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Reducing cancer care costs for patients and families is an important part of the Wisconsin Cancer Plan 2020-2030. |
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Welcome to our new Member Spotlight series! Learn how fellow members are overcoming challenges, advancing equity, and increasing impact.
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Ascension Southeast Wisconsin:
A creative approach to survivorship care during COVID-19
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When COVID-19 made in-person patient education too risky for people with cancer, staff at Ascension Southeast Wisconsin came together to find creative ways to meet their patients’ needs.
Chris Kulas, MSN, RN, survivorship and high-risk program coordinator for Ascension Southeast Wisconsin, shares how they created an online video series, what they hope to do next, and what lessons others can learn from their work.
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Tell us about Ascension SE Wisconsin and the communities you serve?
Kulas: We serve some communities that are affluent, as well as some of the poorest communities in the state. We’re working on meeting the needs of all the people we serve.
We have some areas where the disparities are so high. Working out the insurance and the finances, educating people about cancer care – it’s hard for a lot of people to work through those problems, whether it’s working your way through the health system, or even just getting to appointments.
How did the video series come to be?
Kulas: We wanted to help people learn how to eat healthy and what the benefits are, and how increasing your physical activity can decrease your chances of getting more cancer or a recurrence of cancer. With COVID, it’s been a challenge, so we’ve had to go outside our box and think about what we could do differently.
In a previous position, I created a video to teach patients about medication side effects. It became a best practice for discharging patients from that unit. It seemed so simple, but it’s something we hadn’t thought to do before.
In March 2021, we formed a survivorship committee with people from all parts of the organization, physicians to physical therapy to nutrition.
We came up with five video classes on healthy eating and physical activity. It’s not just enough to say “healthy eating,” because that can mean different things to different people. It’s really important to break it down to explain what a healthy diet means.
We used Google slides for the information for each of the classes. We filmed in conference rooms in the hospital and used space at the hospital in Racine for the cooking videos.
We used all in-house partners. Some of our presenters had past experience in doing demonstration videos, but not everyone. Those who didn’t have experience got comfortable pretty fast. We have a staff videographer who had filmed cooking demos before, so he could help guide us.
Our first video was up and running in June 2021, and our last two videos were posted in November.
What are you planning next?
Kulas: We’re creating a survivorship website for our system so that people can watch the videos with a single click. That way people won’t have to register and provide personal information.
People are wanting to make more [videos]. They’ve really enjoyed the experience. In the future, we might do a grocery store shopping video or a farmer’s market shopping video. I’d love to do a series dedicated to chemo side effects and how to treat fatigue.
The opportunities are endless. It’s just trying to get the right people, the time, and getting it all together.
What are other highlights of your survivorship work?
Kulas: We’ve started a monthly newsletter that we share digitally and have printed copies in clinics, to highlight different things about cancer survivorship. And we’ve started a high-risk cancer program, starting with breast cancer, focused on communities with greater health disparities.
What advice do you have for other organizations?
Kulas: Be creative. Figure out what resource you have and what you can do with it. I learned a lot about what Ascension has available. Educate yourself and then use the resources you already have.
Make sure you’re not being judgmental in helping people learn how to better take care of themselves. There can be a lot of judgment in how we talk about food, diet, and physical activity.
At the end of the day, what inspires you?
Kulas: My mom is a cancer survivor. There is so much opportunity to help people, but she wasn’t given that opportunity. I see the gaps in care that she received and that other people have received. But it doesn’t have to be that way. That’s what motivates me.
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Ascension SE Wisconsin participated in our 2021 Survivorship Community of Practice. Other staff members who made this work possible include: Mark Albertini (audio video specialist), Mandy Mindin, RD, MS, CD, and Andrea Walton, RDN, CD, CSO (dieticians), Sarah Weideman, OT (occupational therapist), Dayna Hein,PT (physical therapist), Deanna Birling, MSN ANP-BC AOCNP (nurse practitioner, radiation oncology), and Sherri Costa MS, RN, AOCNS® (regional manager oncology support services).
THANK YOU!
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Cancer survivorship and survivorship care are important parts of the Wisconsin Cancer Plan 2020-2030. |
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People in active treatment for cancer can be at greater risk of severe infection from COVID-19.
We keep track of articles, studies, and other resources that can inform your work related to COVID-19, vaccine promotion, and the effects on patients with cancer. See below for recent highlights:
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STUDY
- This study of vaccines administered at Children's Wisconsin from January 2019 through December 2020 found the decline in pediatric vaccination in 2020 disproportionately affected children with Medicaid insurance. For example, Hepatitis B vaccination (which prevents liver cancer) declined only 8% among children with commercial insurance, compared to a 19% decline for children with Medicaid.
REPORT
- Administration of a third COVID-19 mRNA vaccine dose as part of a primary series among immunocompromised adults, or as a booster dose among immunocompetent adults, provides improved protection against COVID-19–associated hospitalization.
PRESS RELEASE
- In the largest peer-reviewed study to date examining short-term adverse effects of COVID vaccination in people with cancer, researchers found that mRNA vaccines for COVID-19 are just as safe among people with cancer as they are in people who are cancer-free.
- Read the full report.
REPORT AND BRIEFING
- How has the COVID-19 pandemic affected cancer patients, cancer treatment and research, and the future of cancer science? Learn more in this comprehensive report, including helpful data snapshots and a recording of the Feb. 9th virtual Congressional briefing that included a panel discussion with patients and advocates.
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Emergency "Unwinding" Toolkit for Partners |
Special rules during the COVID-19 emergency have allowed more people to keep BadgerCare Plus and Medicaid benefits. In normal times, Wisconsin reviews information provided by members and renews their participation in Medicaid if they still qualify. That renewal process has been paused, allowing people to keep their health benefits.
In anticipation of the emergency ending in 2022, the Wisconsin Department of Health Services is preparing to “unwind” the special rules and resume the renewal process that was in place before COVID-19.
DHS has created this toolkit for community partners to understand the impact of this expected change and help communicate important messages to patients and community members.
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A new website from the Centers for Disease Control and Prevention offers tools, information, and other resources to help you advance health equity in your cancer work.
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Cancer Care in the Wake of a Cyberattack: How to Prepare and What to Expect |
Cyberattacks are becoming increasingly common among health care organizations. Learn how a cyberattack can impact all aspects of cancer care delivery and how your organization can create preventive measures now.
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Calling Attention to the Role of Race-Driven Societal Determinants of Health on Aggressive Tumor Biology: A Focus on Black Americans |
This report examines social determinants of health and their impacts on cancer outcomes among Black Americans, with an emphasis on structural racism and discriminatory policies and the effects on health.
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Cancers Associated with Human Papillomavirus, United States—2014–2018 |
This data brief explores HPV-related cancers by sex, cancer type, and racial group, using updated data from 2014 to 2018. Each year during that time, about 46,143 new cases of HPV-associated cancers occurred in the US, including about 25,719 among women and about 20,424 among men.
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Incidence of Screening-Detectable Cancers Among Non-Hispanic American Indian and Alaska Native Populations 2014–2018 (Purchased/Referred Care Delivery Areas) |
This data brief examines screening-detectable cancers, specifically colorectal, lung, female breast, and cervical cancers, among non-Hispanic American Indian/Alaska Native populations. The brief looks at data according to sex, cancer type, and IHS region. (Wisconsin is included in the Northern Plains region.)
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WEBINAR
Racism as a Public Health Crisis: The Black Community and Lung Health
Beginning in 2020, elected leaders across the country have passed resolutions declaring racism a public health crisis. According to the American Public Health Association, there have been 231 declarations at local, county, and state levels. Milwaukee County was the first place in the country to make a declaration, and we will hear from one of the key individuals behind that work, Lilliann Paine. We will also hear from thoracic surgeon Dr. Ozuru Ukoha, who will speak to the clinical implications of these declarations and how they must be followed with action. Organized by the American Lung Association.
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Feb. 16
11 am - 12 pm CST
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VIRTUAL WORKSHOP
Innovation in EHRs for Oncology Care, Research, and Surveillance
On February 28 and March 1, 2022, the National Cancer Policy Forum and the Computer Science and Telecommunication Board, will host a 1.5 day public workshop to examine opportunities to improve patient care and outcomes through collaborations to enhance innovation in the development, implementation, and use of electronic health records (EHRs) in oncology care, research, and surveillance.
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VIRTUAL SEMINAR SERIES
HPV Cancer Prevention Program, from St. Jude Children's Research Hospital
Feb. 28 | 12-1:30 pm CST
Addressing Inequities in HPV Vaccination Coverage and HPV Cancers
This seminar will feature an in-depth conversation addressing the disparities associated with HPV vaccination coverage across Black, Indigenous, People of Color (BIPOC) communities.
March 1 | 12-1:30 pm CST
Improving HPV Vaccination Coverage: Starting at Age 9
This seminar will provide an overview of the importance of starting HPV vaccination at age 9 to increase on-time vaccination coverage and optimize prevention of HPV cancers.
March 2 | 12-1:30 pm CST
No Longer Invisible: Learning from Survivors
This seminar will elevate the voices of HPV cancers survivors to improve HPV cancer prevention.
March 3 | 12-1:30 pm CST
Mitigating the Effects of the COVID-19 Pandemic on HPV Vaccination Coverage
This seminar will highlight the urgent need to lessen the effects of the COVID-19 pandemic on HPV vaccination coverage, which has resulted in millions of missed doses and multiple missed opportunities for HPV cancer prevention.
March 4 | 12-1:30 pm CST
Celebrating International HPV Awareness Day 2022
This seminar will focus on raising awareness about HPV cancer prevention and promoting action to increase HPV vaccination coverage.
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Feb. 28 - March 4
For a full list of speakers and to register, click "Learn more."
Participants can register for individual seminars or for the entire series.
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WEBINAR
NCCN Pharmacy Updates: Crossroads of Exercise and Chemotherapy
Exercise and nutrition may be only briefly discussed during treatment planning, and patients may be unwilling to consider exercise during chemotherapy. It is important to provide education and an action plan to outline how exercise may not only reduce side effects from chemotherapy but also help chemotherapy work better and improve survival. As new data emerges, more specific exercise “doses” can be prescribed.
This program is designed to meet the educational needs of pharmacists, physicians, nurses, nurse practitioners, physician assistants and other health care professionals who manage patients with cancer.
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March 10
11 am - 12 pm CST
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Share your upcoming events with fellow members.
Are you planning a workshop, webinar, or other event? We can help promote your events in our Member Events Calendar and in future issues of ENGAGE.
To include your event, please send event details to Alex Faust.
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Save the Date: 2022 Wisconsin Cancer Summit
Please plan to join us for the 2022 Wisconsin Cancer Summit, Oct. 19-20, 2022, at the Edgewater Hotel in Madison!
Stay tuned for more details.
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Do you need print copies of the Wisconsin Cancer Plan?
We offer free print copies of the Wisconsin Cancer Plan 2020-2030 to all our members. To receive yours by mail, please email your name, mailing address, and the number of copies requested to Tina Pap. Thank you!
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Reducing the burden of cancer
for everyone.
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