Background In a changing healthcare landscape, more work needs to be done to explicate challenges with access to quality breast health care and to identify areas in need of process and quality improvement. Continuing its mission to eliminate disparities in breast cancer care, the Metropolitan Chicago Breast Cancer Task Force is focusing its efforts on structural and quality issues, with the goal of identifying gaps in care and processes in order to help low-resource facilities to implement practices aimed at delivering quality care for all. Toward this end, the Task Force is continuing its study of breast cancer care processes in institutions in the Chicago area. The aim of this study is describe the current breast healthcare landscape in Chicago and to explore the related care processes and resources for patients undergoing breast cancer screening, diagnosis, and/or treatment, including precision medicine. This study identifies breast care practices and variations in care processes amenable to quality improvement (QI) interventions. This iteration of our care process study includes an additional focus on changes following the implementation of the Patient Protection and Affordable Care Act (ACA), Illinois Medicaid reform and expansion of Medicaid eligibility. There are three aims to this study: Objective 1: Explore each institution’s current breast care processes across the disease trajectory, including screening, diagnosis, treatment and supportive care, with an emphasis on patients covered under Medicaid. Objective 2: Benchmark and analyze breast care processes across de-identified institutions with the end goal of producing and disseminating a summary report. Objective 3: Evaluate the feasibility of quality improvement initiatives to address care process improvements in low-resource sites, with an assessment of outcomes pre- and post- intervention. Methods The study will utilize three surveys that will be distributed to all participating facilities via the Qualtrics survey platform. The surveys are as follows: • Medicaid Managed Care Survey This survey contains questions related to how Illinois’ Medicaid managed care system has impacted the facility. • Environmental Scan Screening/Diagnosis Survey This survey contains questions related to the facility’s processes around mammography screening, timeframes, communication with patients and providers, diagnostic processes, radiology practices, biopsy and pathology practices and patient satisfaction. • Environmental Scan Treatment Survey The treatment survey contains specialty-specific questions (e.g., pathology, radiologist, surgeon, etc.) which will require responses from different individuals knowledgeable in these areas. Participating facilities will receive an individualized report comparing facility data with aggregated data. In addition, an aggregated report will be developed. Results Preliminary study results should be available in late summer/early fall. Available results will be reported in the poster.

Citation Format: Carla Amato-Martz, Anne Marie Murphy. Breast cancer screening, diagnostic and/or treatment care processes in care institutions in the Chicago area [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B115.