The Cost of Health Care Services Provided to Women Enrolled in a Community-Based Breast and Cervical Cancer Screening Program

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) is a state-federal partnership that provides breast and cervical cancer-related services for low-income women but does not address other health care needs. We describe the annual cost and reimbursement associated with all services delivered to 483 program enrollees at one health care system during 2001-03. The average per-enrollee cost for all clinical services provided was $1,056. However, average revenue was $533 per enrollee ($138 from NBCCEDP and $395 from other sources); the cost of uncompensated care thus averaged $523 per year per enrollee (approximately 50% of total cost). The net cost to the health system was nearly four dollars for each dollar of NBCCEDP revenue. The public health benefit of the NBCCEDP may extend beyond breast and cervical cancer but at a cost of increased uncompensated care borne by participating providers.