TRI-COUNTY — Local healthcare leaders are searching for a solution to the Big Bend region’s lack of mammography services after the August discontinuation of Mammos on the Move, a 10-year-running mobile mammography program run by company Desert Imaging.
“We’ve now lost those services, and the closest place to get a mammography is in Midland-Odessa or El Paso,” said Lynette Brehm, executive director of the Big Bend Regional Hospital District, in a board meeting last week.
It is recommended that women ages 40 to 74 “at average risk for breast cancer” receive mammograms every two years, according to the U.S. Preventive Services Task Force, meaning a significant percentage of the area’s population has been left without access to potentially life-saving screenings that help detect early-stage breast cancer.
The Big Bend Regional Medical Center is proposing that the hospital district invest in a permanent mammogram machine for the hospital as well as associated updates to its X-ray room. Other options, like bringing in another mobile mammography unit, are also being explored.
“We’ve looked at several different options when it comes to mammography, in terms of what if we were to purchase? What if we were to lease? What if we were to look at another mobile unit coming out here and what would that mean?” said Regina Terrazas, director of physician practice management at the hospital.
The hospital district previously made quarterly payments of $6,100 to Desert Imaging for the Mammos on the Move unit to visit Alpine, Terlingua, Marfa and Presidio for about a week total per quarter, with patients being charged $100 per screening. Brehm told The Big Bend Sentinel hospital district payments helped subsidize the service so they would come to the area.
Terrazas said a new estimate that the hospital received to contract with a different mobile mammography unit, Assured Imaging, involved a $5,000 minimum to bring the unit to the area, and a required minimum of 30 studies, or exam of one breast, at $250 per exam, amounting to a total of $12,500 per event in the area.
When Desert Imaging announced it was discontinuing the Mammos on the Move program, the company told Brehm it was a business decision made in part due to tighter state regulations and costs involved with dispatching the mobile unit, according to Marfa Public Radio.
Terrazas explained that the alternative option of purchasing a new permanent 3D mammography machine for the hospital is estimated to cost around $350,000 including shipping, and the hospital is asking the district to invest $250,000 into the equipment.
Upgrades to the hospital’s X-ray room — not necessary, but ideal considering aging equipment — totaled $247,000, she said. “Our building’s been there since 1999 as has most of our equipment, and some of our radiology equipment is aging out,” Terrazas said. “As we look to bring in new services, we also look to upgrade and come up to speed, and part of that is having a digital radiology unit to be able to support the new services and the new equipment that’s coming in as well.”
There’s also the matter of hiring and training a technician to work the new mammography machine, Terrazas explained, an annual personnel cost of around $87,000 the hospital intends to take on. It is possible that temporary technicians could be brought on while permanent staff are being trained, she said. The hospital is also anticipating a lag in the shipment of the mammography machine; it is not likely that it would arrive at the hospital for another six months if approved for purchase, Terrazas said.
Still, a permanent mammography machine for the region would be a long-term investment in healthcare that has serious advantages, she argued, allowing women to receive expanded care locally even though the hospital lacks a cancer center. “It’s not one supporter and everybody’s trying to get to that one supporter. They would be daily services. And then we would have the ultrasound capability, and we have our general surgeon who, if there’s unfortunate results, can do the biopsies and can do the mastectomies,” Terrazas said. “So a patient can have the total care here in our area, versus having to leave the area, with the exception of oncology, of course.”
Hospital district board member Valynda Henington expressed concerns that the cost of the program remained low, noting that the preexisting $100 was still prohibitive for some women. Individuals enrolled in the county indigent care program with the hospital district receive the entire cost of their mammogram covered. Terrazas and Hospital CFO James Bracken explained that the hospital would charge $200 for screenings. In a follow up with The Sentinel, Terrazas said patient’s individual insurance plans will determine the price, and self-pay patients have a reduced rate of $80.
Bracken said the hospital is ready to act “as fast as possible,” on the initiative. “The community needs it,” he said.
But, while they showed overall support for the idea, hospital district board members were hesitant to swiftly approve the costly expenditures for the new mammography machine and X-ray room upgrades given that they were already on the precipice of passing their upcoming fiscal year budget that evening. It is likely that the district would have to dip into its fund balance to cover the initiative, which is healthy at $7 million.
“I think it’s definitely needed and a line of investment that we could partner with y’all on and work out something,” said Board Chairman Buddy Cavness.
Brehm told The Sentinel that discussions with the hospital will certainly continue, but the hospital district’s current budget “doesn’t include an extra $500,000 of allocated funds.”
“Every dollar of our budget is thoughtfully allocated,” Brehm said. “The board needs to learn more about the costs associated with bringing a mammography here and how a partnership could potentially work before an informed decision is made.”
