TMIST Trial Expands Mammography Access to the Uninsured

Etta Pisano 16May17_0002 headshotThis post was contributed by Etta Pisano, MD, FACR, principal investigator of the Tomosynthesis Mammographic Imaging Screening Trial (TMIST).

With 70 sites up and running – and 60 more in the pipeline – TMIST is picking up speed.

One of the factors that I am proud to highlight is that radiologists are very interested in using TMIST participation to offer breast cancer screening to women in their community who may not otherwise have access to these lifesaving exams.

TMIST is one of a comparatively few large clinical trials that offers provider reimbursement for women who qualify for charity care at a participating site.

For the initial exam for each woman enrolled (insured or uninsured), sites receive $500. If the woman is insured, they also receive the usual payment from the insurer. If the woman is uninsured and qualifies for charity care at the site, sites receive an additional $138.17 from TMIST for this initial exam.

For each follow-up screening for insured women, TMIST pays sites $150 on top of the insurance payment. For each follow-up exam for uninsured women who qualify for charity care at the site, TMIST pays sites $150 plus an additional $138.17.

This possible total $288.17 TMIST payment ($150 + $138.17) for each follow-up exam for uninsured patients may be triple that paid to providers for such services by major breast cancer care charitable organizations. 

A recently approved $30,000 reimbursement advance can help select facilities immediately hire a research assistant as an on-site coordinator and avoid added responsibilities to existing staff. This can be particularly impactful for sites in underserved areas — including small and rural practice providers.

An added benefit is that, in addition to offering screening to women who may not get this care otherwise, we are expanding representation in clinical trials. This can help ensure that TMIST conclusions will be more generalizable across populations – strengthening its real-world impact.

I am proud to lead the TMIST trial and proud of the radiologists taking part.

As we will ultimately recruit 165,000 women to TMIST, at up to 150 sites, we still need more radiology facilities to take part.

I invite you to visit to find out how TMIST participation can strengthen your practice, enable you to author papers published in major medical journals, help shape future breast cancer screening, and expand access to the underserved in your communities.

  • Have questions about TMIST? Please email— we will answer your questions and walk you through how to get started.

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