Predictive AI Model Identifies 55% of Commercially Insured Women Unlikely to Get a Mammogram

Cedar Gate’s analysis of nearly 2.4 million women in its proprietary national Healthcare Benchmark Database reveals important trends in breast cancer screening

GREENWICH, Conn.--(BUSINESS WIRE)--Cedar Gate Technologies (Cedar Gate) finds that of nearly 2.4 million women in its commercially insured Healthcare Benchmark Database, 55% are unlikely to get a recommended mammogram based on the company’s predictive AI model.

The model surfaces a probability score for whether or not a woman is likely to get a mammogram based on U.S. Preventive Services Task Force (USPSTF) guidelines. These guidelines recommend that women between the ages of 40 and 75 at average risk of developing breast cancer have a screening mammogram once every two years. More than 1.3 million (54.6%) of 2,388,731 women in the recommended group fell below Cedar Gate’s predictive scoring threshold. These women were identified as “unlikely” to get a mammogram.

With data from more than 12 million member lives, Cedar Gate’s proprietary national Health Benchmark Database enables payers, self-funded employers, brokers, consultants, and providers to better understand patient and member needs. Healthcare delivery organizations can use the information to proactively identify and allocate resources that increase the number of women who get their recommended mammogram screenings, resulting in better outcomes for everyone.

“Breast Cancer Awareness Month is a time when we all focus on the importance of mammograms for saving lives,” said David B. Snow, Jr., CEO of Cedar Gate. “Our data highlights the reality that millions of women still do not get their recommended mammograms. We know that early diagnosis is important to improve treatment options and outcomes for someone with breast cancer. This data can help healthcare organizations identify patients and members in their population who are unlikely to get mammograms, and design outreach programs to increase lifesaving screenings.”

The data also shows that the average age of commercially insured patients in the Cedar Gate database with breast cancer as a primary diagnosis is 58 years. This is several years younger than the median age of 63 years for all populations (including people on Medicare), according to cancer.net. It highlights the value of capturing and analyzing information on targeted patient populations like those in Cedar Gate’s Health Benchmark Database.

Additionally, the data shows a marked increase of women with estrogen- and progesterone-receptor-positive cancers (ER+ / PR+) who received a genetic test between July 2021 and June 2022 compared to the previous year, rising 34% from 11% to 15%. Genetic testing can reveal whether someone has one of nine known and actionable genetic mutations. Understanding these genetic mutations can inform surveillance recommendations, care plans, and treatment. The data supports trends showing that genetic tests are becoming more accessible for people at higher-than-average risk of developing breast cancer, or when recommended by a doctor.

“In value-based care models, where wellness, prevention, and early interventions are at the center of care, leveraging data like this from our Healthcare Benchmark Database helps payers, providers, and employers take actions that support access and encourage health in their populations,” continued Snow.

According to the Susan G. Komen organization, more than 350,000 new cases of invasive breast cancer and ductal carcinoma in situ (DCIS) will be diagnosed in 2023 in the United States. More than 43,000 people will die as a result of breast cancer this year. Regular screening mammograms are still one of the best ways to catch breast cancer early. Early diagnosis can lead to more treatment options, according to the CDC, and can lower the risk of dying.

About Cedar Gate Technologies:

Cedar Gate enables payers, providers, employers, and service administrators to excel at value-based care with a unified technology and services platform delivering analytics, population health, and payment technology on a single data management foundation. From primary care attribution, to bundled payments, to capitation, Cedar Gate is improving clinical, financial, and operational outcomes for every payment model in all lines of business.