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Anthem Blue Cross Blue Shield’s Budget Plan


Breast cancer screenings can help diagnose the disease in its early stages and provide a more effective treatment to patients. The senior management of Anthem Blue Cross Blue Shield (ABCBS) decided to proceed with the annual initiative of offering mammograms to their clients without additional payments in October. By using the cost and benefit analysis for the strategic plan, it can be concluded that ABC would benefit from the free of charge breast cancer screenings. For each patient that is diagnosed through this process, ABC would be able to retain $310,014. This paper aims to offer a five-year budget plan for ACB and offer strategies to mitigate risks from the external environment.

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The budget for the Breast Cancer Screening Initiative

A five-year budget plan was completed to calculate the direct and indirect spending that ABC would have to make; the Appendix presents these calculations. The budget for the initiative consists of the mammogram costs, which include salary payment for medical personnel and actual procedure expenses. It was estimated in the cost and benefit analysis that ABC has to perform at least eight screenings based on the breast cancer prevalence statistics (American Cancer Society, n.d.).

ABC would have to fund the execution of the procedure because, according to the plan, these mammograms are provided free of charge. Additionally, these expenses will be in place once a year because the event will be dedicated to the Breast Cancer Awareness month.

It is vital to estimate the number of patients that establishments would be able to facilitate breast cancer screenings. According to Frazer and Wylie (2018), “standard diagnostic mammography takes between 10–15 minutes” (para. 5).

However, women with breast implants require up to 30 minutes to receive clear images. Therefore, on average, a procedure would take 22,5 minutes. According to Patterson et al. (2018), the typical duration of a shift for a medical professional in the US is from 8 to 12 hours, for this calculation, the standard eight-hour shift is taken into account. In addition, the standard cost of one mammogram is estimated at $101 per patient (Ekwueme et al., 2014). Considering this information, ABC would be able to perform 20,4 mammograms with one team of professionals, which would cost $2060,4 in total. ABC would have to fund this expanse, either a loan or by investing directly.

It is essential to consider an increase in the cost of healthcare services to calculate the spending over a five-year period. On average, the price of these procedures increases by 7,6% in Indiana, which was used to calculate the budget for years 2-5 (“Average annual percent growth in health care,” n.d.). This was applied for both procedure cost estimation and treatment payments in years 2-5. Thus, the data provides a clear perspective of the costs and benefits over a five year period.

ABC will be able to benefit from this initiative by lowering the insurance payment costs for breast cancer treatments in the late stages. With this screening initiative, approximately 2, women would be diagnosed with breast cancer. For this analysis, the costs of treatment for two women will be considered. For both, the difference between early-stage cancer and late-stage cancer is estimated at $148,100. The price was calculated by deducting $134,687, which is a payment that ABC would have to make for stage IV treatment, by $60,637, which is the cost of stage I intervention (Kakushadze, Raghubanshi, & Yu, 2017). Although the profit is indirect, ABC would benefit significantly from saving its financials by applying breast cancer screenings.

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The marketing expenses are not included in the budget plan because the standard procedure that ABC employs for screenings involves health coaches or referral specialist calling clients of appropriate age and gender that may be interested in the initiative. A computerized dialing system with a pre-recorded message is used as well. These approaches are standard for the establishment; thus, no investment in this process is required. Moreover, Thomas (2014) states that “healthcare marketing like marketing in other sectors of the economy experienced an electronic revolution” (p. 6). ABC’s social media accounts can be used to promote breast cancer screenings.

The criteria that can be used to evaluate the evidence are is the credibility of sources that were used when collecting data. The statistics, cost of mammograms, shift duration, and the annual increase in the price of healthcare services were considered. The information was taken from peer-reviewed journal articles by Kakushadze et al. (2017), Patterson et al. (2018). Thus, the information is viable and can be used for projection of earnings and spending.

Implementation Strategy

The first step is identifying the source of investment for the mammogram initiative. Due to the fact that projected investment in the event is estimated at $2060.4 in the first year, the executives may decide to fund the project without obtaining a loan. The project and implementation plan have to be reviewed and approved by ABC’s executives, which may take an additional two months. Therefore, ABC should be fully prepared to implement the project in October 2019.

The second step in employing the initiative is identifying a timeline for execution. It is established that mammograms should be carried out in October; thus, the project should take place on October 1st. The preparation for the project will include management identifying health coaches and referral specialists that will be inviting women to participate. In addition, a message should be pre-recorded for requesting prospective clients to a healthcare facility in Indiana.

It should be done before the set date in October; furthermore, ABC should begin calling the participants a month in advance. ABC can use its existing database of clients to identify women over the age of fifty in Indiana. The referral specialists and coaches should register individuals who are interested in the initiative. Pre-recorded messages can be used to remind people of the event several days before ABC carries out the screening.

Social media and ABC’s website can be used as part of a marketing plan for the strategy. This would allow the company to obtain prospective clients by advertising its free of charge event online. The company should use the existing social media resources and ensure that people who want to attend register on ABC’s website. These two approaches would have to be employed to ensure that ABC can engage people in participating in the initiative.

The final step is to inform all stakeholders about the possible adverse outcomes of procedures because ABC values its patients and adheres to medical standards, both personal and prospective participants should be consulted on the issue of over-diagnosing. It is required because not every form of early-stage cancer develops into a disease that is difficult to treat. Houssami (2017) states that it is a crucial component of preventative breast cancer screenings. The management team of ABC should hold a meeting before the event to inform the personnel of this aspect and ensure that they would consult attendants regarding the problem. It will ensure that ABC can achieve quality improvement through the proposed strategy by delivering proper health care services.

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Ethical and Cultural Considerations

The primary moral concern is the number of participants that may want to attend the event. There are several ways ABC can mitigate this risk and provide people with free of charge screening. Firstly, ABC should partner with other organizations that offer similar procedures in Indiana. In this way, ABC’s personnel will be able to refer individuals to partner organizations. In case ABC receives more registrations then initially anticipated, the management should apply for external funding provided by non-profit organizations to provide the service for everyone who registered.

Knowledge Gaps

The knowledge gap is the number of calls ABC employees would have to make to ensure a specific number of people would visit the facility in October. While the specialists will be registering participants in advance, it can be argued that not everyone would attend. This missing information would allow estimating the expected number of people more precisely, and thus adjusting the calculations for the budget accordingly.

Impact of the Initiative on ABC

Once implemented, the annual breast cancer screenings provided by ABC should help establish the company’s image as a reliable healthcare provider that services the needs of the community. The negative aspects that affect the initiative are connected to a possibility that no breast cancer cases would be detected. In this case, no benefit in regards to decreased insurance payments will be in place. The assumption regarding the prevalence of breast cancer was made in regard to the statistics provided by the American Cancer Society (n.d.). This component cannot be mitigated within a small sample size. In this case, ABC would have to consider expanding the initiative to provide screenings to more individuals, which would increase the chances of cancer detection.

Strategies to ensure that Plan is Viable

The primary environmental factor that can affect the initiative of ABC is a significant decrease in breast cancer cases in the US. Since 2000, the number of people affected by the disease has been lowering each year due to prevention and timely treatments (“U.S. breast cancer statistics,” 2018). However, the number of cases and prevalence suggest that despite the positive trend, a large number of people are affected by breast cancer. To mitigate the possible risk, ABC should monitor the statistical data each year to identify whether it is beneficial to carry out the initiative. The knowledge gap in regards to this aspect includes the rate of decrease, which would allow determining the viability of the endeavor in the future.


Overall, the five-year budget plan for ABC shows that the breast cancer screening initiative will ensure that the company can benefit from the free of charge screenings. The initial investment in the first year is estimated at $2060.4, while the benefit should provide ABC with an additional saving of $148,100 in the first year. Possible risks can be mitigated by monitoring the dynamics of breast cancer prevalence and identifying the need for the initiative at a particular period.


5-year Budget Plan for ABC (created by the author).

FY 2019
Year 1
FY 2020
Year 2
FY 2021
Year 3
FY 2022
Year 4
FY 2023
Year 5
Savings from the initiative $148,100 $159,355 $171,466 $184,498 $198,520 $861,939
Total Receipts $148,100 $159,355.6 $171,466.6 $184,498 $198,520 $861,939
Operating Payments
Cost of Procedures $2060 $2216 $2385.48 $2566 $2761 $11,991
Operating Surplus/Deficit $146,040 $157,139 $169,081 $181,923 $195,759 $850,011
Cash Surplus/Deficit $146,040 $157,139 $169,081 $181,923 $195,759 $850,011
Closing Cash Balance $146,040 $303,179 $472,260 $654,183 $849,942 $850,11


American Cancer Society. (n.d.). Managing the costs of your cancer treatment

Average annual percent growth in health care expenditures by state of provider. (n.d.).

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Frazer, H., & Wiley, L. (2018). Diagnostic mammography.

Houssami, N. (2017). Overdiagnosis of breast cancer in population screening: Does it make breast screening worthless? Cancer Biology & Medicine, 14(1), 1-8.

Kakushadze, Z., Raghubanshi, R., & Yu, W. (2017). Estimating cost savings from early cancer diagnosis. Data, 2(3), 30. Web.

Patterson, P. D., Runyon, M. S., J. Higgins, S., Weaver, M. D., Teasley, E. D., Kroemer, A. J., … Martin-Gill, C. (2018) Shorter versus longer shift durations to mitigate fatigue and fatigue-related risks in emergency medical services personnel and related shift workers: A systematic review. Prehospital Emergency Care, 22(1), 28-36. Web.

Thomas, R. K. (2014). Marketing health services (3rd ed.). Chicago, IL: AUPHA/HAP.

U.S. breast cancer statistics. (2018).

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