BY ALEJANDRA O’CONNELL-DOMENECH | When it comes to helping breast cancer survivors, MetroPlus Health Plan is dedicated to ensuring that all of them receive the full care they deserve.
“As an insurer we somewhat go against the current,” said Dr. Tayla Schwartz, president and CEO of MetroPlus Health Plan, which covers over half a million New Yorkers. “We want to focus on vulnerable populations that need health care, the populations that need support. We don’t shy away from them, we proactively try to bring them into MetroPlus . . . because we know that we can provide them with comprehensive support here, true hands on what we call 360 support with whatever they need.”
In order to ensure that members are staying up to date with yearly exams, MetroPlus Health constantly checks member data to determine who are the women who qualify for or need breast cancer screenings. Once the company determines that a member should see a provider, they use all means of communication, phone calls, texts, e-mails, letters to get in touch. In order to best communicate with a diverse membership, the health plan tries to contact members in the language that they speak and boasts a multi-lingual staff along with easy access to language lines.
If for some reason a member is unable to get in touch with her physician, a MetroPlus Health employee can call a provider and schedule and appointment for her. To encourage members to prioritize their health, MetroPlus incentivizes women to schedule a yearly mammogram by offering reward points which can be used to purchase items from the company’s rewards catalogue. In order to not just have the responsibility placed on the member, MetroPlus also financially incentivizes doctors to make sure that their patients are up to date on their early exams.
MetroPlus Health understands that it is not always easy for members to make to a doctor’s appointment and will bring health care to the community by holding public events where women can be screened on the spot. In 2018, there were 37, 403 mammograms performed on MetroPlus Health members. The health plan currently has 1,600 members undergoing treatment for breast cancer, a number that has stayed stable over the last five years.
During member data analysis and out in communities, MetroPlus Health takes special care to encourage higher risk demographics, especially African American women, to undergo breast cancer screenings. According to the Center for Disease Control, black women are 40 percent more likely to die of breast cancer than white women.
“It’s very clear that any time you want to make a dent in a health issue, there isn’t one approach that works,” said Schwartz. “You have to attack it from multiple angles.”
A Doctor’s Passion
MetroPlus Health Plan is not your typical health insurance program and that is in part because of the passion and care of Dr. Tayla Schwartz, president and CEO of MetroPlus Health Plan, a pediatrician by training. Dr. Schwartz has known that she wanted to be a physician since “the time she could speak” and brings her need to care for other into every position she holds.
“We are tremendously lucky to be who we are,” said Dr. Schwartz.
After serving in the military in her native Israel, Dr. Schwartz studied at the Sackler School of Medicine and came to New York for a residency in Pediatrics at Maimonides Medical Center in Brooklyn. Schwartz worked as a pediatrician at the Children’s National Medical Center in Washington D.C. and simultaneously conducted basic research at the National Institute of Health. Two years after her fellowship, Schwartz began working for a healthcare consulting firm where she was first able to view healthcare “through a different lens” and subsequently became more interested in the business side of healthcare. Schwartz has been president and CEO of MetroPlus Health Plan since May 2019.
