UICC World Cancer Congress 2006

•Objective: The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) is a federally-funded effort designed to increase both access to and the quality of breast and cervical cancer screening for uninsured, low-income women; priority populations include women age 50-64, culturally or geographically isolated women, and those who have never or rarely been screened for cervical cancer. The NBCCEDP operates through Cooperative Agreements with states, tribal governments or consortia, and US territories. •Methods: The President's Management Agenda requires that the NBCCEDP demonstrates increasing screening volume; at the same time, Congressional allocations for the program are stable or decreasing. Identifying areas in which operations can be streamlined, as well as evaluating the effectiveness of specific current efforts, are among the methods used to divert funds from unnecessary expenses to screening services. In addition, a performance-based funding approach assists CDC to direct funds to those programs most likely to use them well. •Results: Case management and billing appear to be 2 areas that absorb large amounts of funding unnecessarily. Recommendations regarding streamlined approaches to these components must be balanced against the need to ensure quality care for clients. Performance-based funding approaches, at a minimum, redistribute funds to programs that can maintain or increase volume while maintaining quality and fiscal accountability.