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In this newsletter...
Reminder: Updates effective February 1, 2024
You should have received information about the 2024 Sage Program changes in our previous communications December and January. As a refresher, below are the program changes that are currently in effect:
As of February 1, 2024, Sage no longer provides payment for:
- Breast and cervical cancer screening and diagnostic services for women, including transgender males and females, 21 to 29 years of age.
- Breast and cervical cancer screening and diagnostic services for those ages 65 and older.
- Magnetic Resonance Imaging (MRI).
- More than one office visit CPT charge for each eligible client per date of service. Sage will pay for one office visit CPT per date of service billed on a professional claim OR one office visit CPT per date of service billed on an institutional claim.
We have a Frequently Asked Questions page on our website that has answers to common questions we’ve received.
You can watch the recording of the January 2024 Office Hours on our website.
Please reach out to Haley Storms-Kruchten haley.storms-kruchten@state.mn.us or Carlie Koberstine carlie.koberstine@state.mn.us with questions.
Improving health outcomes
The burden of cancer and other chronic diseases falls more heavily on certain communities, especially Black Minnesotans. The Sage Program works with partners across Minnesota to reduce health disparities not only in cancer, but heart health as well.
Breast cancer is the most diagnosed cancer in Minnesota. It accounts for 31% of cancers diagnosed in women in Minnesota. Forty-one percent of late-stage (stage 4) cancers are diagnosed in Black women compared to 28% of white non-Hispanic women. Black women are also less likely to survive their breast cancer five years after diagnosis.
Black women are more likely to be diagnosed later when the cancer has spread. They are also more likely to have:
- Less access to high quality prevention, early detection, and treatment services
- Lower likelihood of receiving care
- Higher likelihood of delay in starting treatment
Factors such as being able to find and afford nutritious food, experiencing discrimination and violence, or having safe housing and transportation, quality education, and a trusted support system all contribute to these disparities. Systemic racism and discrimination-related stress also impacts communities of color, making it more difficult to access care and resources that support health.
Le Me Se Se (meaning Good Health in Ewe) is an eight-month health and lifestyle improvement program offered through SagePlus to provide culturally relevant programming to reduce the risk of heart disease and stroke in women of African descent.
The program’s curriculum was designed through a partnership with MDH’s Stairstep Foundation, Black Nurses Rock-Twin Cities, Messianic Care PLLC, and the U of M Food Extension Program in a collaborative effort to create effective and culturally relevant course materials for the participants to stay engaged throughout the program.
Each participant was connected to a cardiac coordinator who served as their health coach and support person to be successful in completing the program, which included activities and lectures focused on cardiac physiology, participants’ health status in relation to the heart, goal setting, nutrition, and exercise. Sessions were taught by a team of physicians, therapists, nurses, dieticians, and fitness instructors. Some of the teachings involved field trips to a spice shop to learn about salt alternatives and cooking demonstrations with foods and recipes representing their culture. Participants were given weekly assignments to complete and discuss with their cardiac coordinator and they participated in weekly exercise programming like Zumba and line dancing.
Over 50 women participated in the program with the first cohort offered in the spring of 2022 and the second cohort in December 2022. Many of the women were recruited through wellness coordinators at their church. Focus groups were held with participants and cardiac coordinators to evaluate the program.
For more information on the SagePlus Program and how you can support patients during Heart Health Month, please contact Kay Herzfeld, kay.herzfeld@state.mn.us.
Black History Month Outreach
The Stairstep Foundation collaborated with several community organizations to share cancer awareness for Black History Month. In collaboration with 2nd Chance Outreach’s “Sound of Gospel Musical” at the Cowles Center, Stairstep was able to share awareness of colon cancer using the inflatable colon full of information and insight. The colon was strategically placed as an extension of the corridor leading to the restrooms for the Cowles Center. When an attendee requested directions to the restroom, the consistent directions were, head back to the lobby and “through the colon!”
Stairstep was able to engage over 1400 attendees with visualization of the colon, the brochures on the Colon Cancer Coalition resources and Exact Sciences information on Cologuard testing kits. They also had the support of Black Nurses Rock members to give education and insight to those perusing through the colon.
Community Partners: Colon Cancer Coalition and Exact Sciences
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Resources on the Sage website
As a reminder, past webinar recordings can be found on our Sage Screening Programs Video webpage. Webinar topics include general Sage Program information, Cancer Screening Quality Improvement, breast health, chemo drug shortage, and the 2024 Sage Program changes.
We recently updated our website! You can now find some helpful training resources such as a training presentation, orientation checklist, and Sage overview on our Sage Program Resources for Providers and Professionals webpage.
Become an MA-BC presumptive grantor to help your patients
The Medical Assistance for Breast or Cervical Cancer (MA-BC) program from the Minnesota Department of Human Services provides Medical Assistance coverage to uninsured Minnesotans who are eligible for and enrolled in the Sage Screening Program and in need of treatment services for a breast or cervical cancer or pre-cancer of the cervix. Patients must meet Sage eligibility guidelines at the time they are diagnosed.
Patients eligible for MA-BC must:
- Have been screened and diagnosed through the Sage Program (must have met eligibility criteria at the time of diagnosis)
- Be under the age of 65
- Have no creditable medical insurance
If you have a patient who is diagnosed with a breast cancer, cervical cancer or pre-cancer that requires treatment and you need assistance with a referral to the MA-BC treatment resource, please connect with the Sage Program Follow-Up Coordinator, Nikki Kuechenmeister at nikki.kuechenmeister@state.mn.us. or 651-201-5904.
Our patients need your help! Please consider having a staff member at your clinic complete the Presumptive Grantor training. It is a simple and easy process that allows your clinic to help patients get needed MA-BC coverage so they can start breast or cervical cancer treatment immediately.
Find out how to become an MA-BC Presumptive Grantor on our Following Up On Abnormal Results webpage.
Billing
Data entry of patient forms is delayed by roughly two months due to staffing shortages. This backlog causes inaccurate pending claim messaging in the paper remit. Action should focus on claims listed under the “WAIT STATUS P1: ACTION NEEDED: Sage data entry is current for these dates of service” as those claims are most likely missing patient information. Claims listed under “WAIT STATUS P2: NOTE: Forms with these DOS not entered yet. No action may be needed.” are currently just confirming receipt of the claim and pending data entry.
Since Sage does not have capability to exchange the EDI 276/277 Claim Status Inquiry and Response files, providers must review the paper remit mailed to them after each payment to learn the status of pending claims.
Cancer Screening Quality Improvement (CSQI)
The Sage Program only reimburses for breast and cervical cancer screening at all Sage clinics. The CSQI Program (formally called the Systems Change Program and Scopes) provides grant funding to eligible primary care clinics to help support the implementation of evidence-based interventions that have been demonstrated to increase breast, cervical, and colorectal cancer screening rates within their clinic population. The CSQI Program partners with clinics serving communities disproportionately burdened by cancer and can reimburse for some follow-up colonoscopies for their CSQI partner clinics depending on criteria outlined within the grant agreement.
For more information, contact Michelle Brasure, michelle.brasure@state.mn.us, Brianna Longeway, brianna.longeway@state.mn.us or Marie Tran, marie.tran@state.mn.us.
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