best practices handbook for health plans

“Thank you! This is exactly the type of information health plans need to pass to one another to improve partnership/collaboration, as the consumer will benefit at the end.”

“I really enjoyed that each of the health plans featured in the toolkit highlights a different intervention or opportunity. That gives our partners many approaches to choose from.”

Colorectal Cancer Screening Best Practices Handbook for Health Plans

Health plans have an essential role to play in the effort to screen more Americans for colorectal cancer, particularly given that seven out of 10 people who are unscreened are covered by insurance.

Colorectal Cancer Screening Best Practices Handbook for Health Plans, provides a first-of-its-kind compilation of best practices, case studies, templates and tools, that will kick start or infuse health plans’ efforts to save more lives and prevent more cancers.

To develop the handbook, the NCCRT convened an advisory group of health plan experts and interviewed high-performing health plans to understand what works and what doesn’t when it comes to increasing screening among members. Thank you to the many individuals and organizations who contributed their time and expertise to developing this much requested resource.

In the future, we hope to update this handbook with more case studies from high-performing health plans. If you have a story to share about how your health plan has worked to raise colorectal cancer screening rates, please email nccrt@cancer.org.

NCCRT’s issue brief, The Importance of Waiving Cost-sharing for Follow-up Colonoscopies, provides additional information on the colonoscopy copay issue.

View the March 28, 2017 webinar introducing the Handbook for a guided tour of the best practices, case studies, and templates and tools found within the handbook, and hear from one of the profiled health plans.

Colorectal Cancer Screening Best Practices Handbook For Health Plans

Colorectal Cancer Screening Best Practices Handbook for Health Plans – March 28, 2017

This webinar introduced the new NCCRT Colorectal Cancer Screening Best Practices Handbook for Health Plans. The purpose of this handbook is to provide health plans with advice on the design and delivery of effective colorectal cancer screening programs. The webinar provided participants with a guided tour of the best practices, case studies, and templates and tools found within the handbook, including a deeper dive into the exemplary practices for one of the profiled health plans.

Speakers:

  • Tamara O’Shaughnessy, QNA Group
  • Anshul Dixit, MD, MPH, MBA, Wellmark Blue Cross and Blue Shield

“This was one of the best colorectal cancer presentations, and it also provided information we can readily utilize with our current health plans in support of the 80% by 2018 initiative.”

Paid Leave Policies for Cancer Screenings

The New York State Department of Health offers resources to help employers develop an effective policy of providing paid leave for employee colorectal cancer screenings (breast and cervical are also covered).

The resources make the case for employers that by providing paid leave for cancer screenings, employers may realize a healthier workforce and be able to reduce expenses on worker compensation and disability costs, replacement costs for ill or injured employees who are absent, and recruitment and training costs for new employees. The website also walks employers through elements of an effective policy on paid leave, such as including union leadership in the process considering Employment Retirement Income and Security Act (ERISA) requirements.

Thank you to NCCRT Steering Committee member Dr. Heather Dacus for sharing these resources.

Evaluation: The content and messaging was developed based on information gathered from literature searches and from feedback from contractors implementing paid leave about common barriers they encountered when promoting the work.

Permissions: Made publicly available online through the New York State Department of Health.

Publication date: May 2016

Post date: September 20, 2017

Contact: Email comments, questions, and suggestions to CanServ@health.ny.gov.

Waiving Colonoscopy Co-Pays

Waiving Colonoscopy Co-pays – April 12, 2016

This webinar explained what’s covered with respect to colorectal cancer screening, what’s not covered and how to code for it; provided an update on federal and state efforts to remove cost sharing for colorectal cancer screening; and described a case study in which Gateway Health of Pennsylvania plan removed copays for colonoscopies following positive FIT tests. Learn more about the cost-sharing issue in the brief: The Importance of Waiving Cost-sharing for Follow-up Colonoscopies: Action Steps for Health Plans.

Speakers:

  • Joel Brill, MD, American Gastroenterological Association
  • Caroline Powers, American Cancer Society Cancer Action Network, Inc.
  • Marnie Schilken, MPH, Gateway Health

The Importance of Waiving Cost-sharing for Follow-up Colonoscopies: Action Steps for Health Plans

The Affordable Care Act (ACA) eliminates cost-sharing for United States Preventive Services Task Force (USPSTF) – recommended preventative services for individuals who are privately insured, including screening for colorectal cancer by high sensitivity stool test or colonoscopy for adults ages 50 and 75.* Some health plans, however, apply cost-sharing to colonoscopies that follow a positive stool test. This creates a financial incentive for patients to select the more costly and invasive colonoscopy as their initial test. Additionally, this cost-sharing creates a financial disincentive that may lead patients to forego the follow-up test that they need.

This Issue Brief gives an overview of this issue and makes a request to health plans to waive cost-sharing for members when colonoscopy is ordered as follow-up to a positive stool test or other colorectal cancer screening test, just as cost-sharing is waived for colonoscopy when it is selected as the first-line screening exam.

Learn more in Colorectal Cancer Screening Best Practices Handbook for Health Plans, a compilation of best practices, case studies, templates and tools.

*The ACA preventive services requirements do not apply to “grandfathered” health plans that were in existence prior to March 23, 2010, as long as such plans continue to meet certain standards for grandfathered plans.