Supporting breast cancer patients through case management at Arkansas Blue Cross

As a nurse case manager specializing in oncology at Arkansas Blue Cross and Blue Shield, Kristianna Goodson has seen firsthand the impact that breast cancer can have on individuals and their families. With one in eight women being diagnosed with breast cancer at some point in her life, it’s no surprise that many of the members she works with are dealing with this diagnosis.

Goodson and other nurses at Arkansas Blue Cross provide comprehensive case management services to breast cancer patients, including education, support and navigation through the healthcare system. “We’re here for the types of questions they may not be getting answered during a quick doctor’s visit,” she explained. “We help fill in the gaps for them.”

Their approach is centered around building trusting relationships with patients and their families. “Once I call and engage a member who has breast cancer, I’m their nurse case manager,” Goodson said. “They aren’t talking to different people each time. Their Arkansas Blue Cross case manager becomes the person they trust to get them clear answers and help them sort through what they need to do.”

Building trusting relationships, one phone call at a time

It’s a relationship that takes place entirely by phone, but Goodson said the bonds that form between members and case managers are real, often building over years of calls.

“Breast cancer is usually a long-term disease,” she explained, “so we’re going through it all with them, from waiting on initial testing, through different treatments or surgeries, the whole process. If their cancer advances to the point they need hospice, we’re reaching out to them and their caregivers during that time, too, to make sure their needs are met. But many breast cancer patients, even with metastatic disease, can now live 20 years or more.”

In her experience, she said members in breast cancer case management tend to be thankful for the support. “We help them understand what’s happening in lay terms. We’re trying to make sure they really understand what to expect and what their options are, and we have the time and space to do that.

Goodson said loneliness and isolation are real problems for many breast cancer patients, who are often women in their 60s.

“Members are often glad to have someone to talk with about what they’re going through. A lot of what we do is support,” she said. “We listen and comfort and try to help them understand what’s going on. Often, they have fears about things they may have misunderstood, or they’ve jumped down a rabbit hole on the internet and have gotten wrong information. We give them some knowledge and perspective and help them navigate everything.”

Targeted treatments

Treatment protocols are moving toward more personalized care. “Treatment used to be more, ‘You have breast cancer. Everybody’s going get this first-line treatment, then everybody gets this other treatment. And then if you fail that, then you get this next thing.’ Now they’re able to personalize the treatment protocols much more to the individual and the type of mutations their tumors have,” Goodson said.

She said the good thing about a breast cancer diagnosis compared to some other cancers is that there is enormous awareness, knowledge and research about breast cancer. “There are more and more treatments available, so women do tend to live a lot longer than with some other cancers,” she said. “Over the last 10 or 15 years of my career, I’ve seen so many new drugs become available and new treatment protocols to prolong life.”

Promoting prevention through workforce communications

Through her many years in the field, Goodson has seen the importance of preventive care in addressing breast cancer. “I’m a big advocate for getting regular mammograms. I’d love to see more people get preventive screenings and regularly visit a primary care provider,” she said. “So often, I hear patients say they don’t have a doctor because they’re never sick. But just because you don’t get the flu doesn’t mean you don’t have diabetes or heart disease or other chronic things going on with you. Primary care visits can help uncover things that may be wrong so PCPs can help you treat them before they cause serious complications like hospitalizations.”

Employers can play a critical role in encouraging their employees to prioritize preventive care and health screenings. By sharing communications about available benefits, such as virtual health options or preventive care coverage, employers can help their employees stay healthy and avoid costly medical issues down the line.

“So often, the people we talk to don’t know what benefits they have,” Goodson said. “They miss out on accessing benefits that can lower costs and improve their health simply because they don’t know about them. There’s a real opportunity to get more information out there, whether by posting it in breakrooms or discussing at meetings or having it in employee communications.”

Arkansas Blue Cross offers a number of free communications materials that employers can distribute to their employees, covering everything from the basics of health insurance to specifics of the programs and benefits the health plan may offer.

Meaningful work

While dedicating her life to cancer patients is not the easiest path, Goodson said helping people is why she got into the field and chose to work at Arkansas Blue Cross.

“At the end of the day, we want to know we have helped someone ease their concerns for the day or make them feel better in that particular moment,” she said.

“When you talk to somebody who says, ‘I was really in a bad place before you called, but I always feel so much lighter and better after I talk to you because you help me understand everything,’ how do you not feel good when someone says something like that to you? That’s always the goal: to make them feel better than before you called.”