Improving Colorectal cancer Screening: Promising Practices for State Medicaid Agencies

This report follows up on a 2015 report commissioned by the NCCRT, Colorectal Cancer Initiatives in Medicaid Agencies—A National Review. That report broadly described the activities being undertaken by Medicaid programs in all 50 states, identifying ten states that had adopted more robust approaches to colorectal cancer screening.

To develop a deeper understanding of how these higher-performing states are approaching the challenges of colorectal cancer screening, follow-up research was conducted with several of the states (Arizona, Maryland, Minnesota, Montana, New York, and Oregon) that had progressed further on their efforts. 

Thus, this guide establishes nine practices that have shown sufficient promise to merit consideration by other state Medicaid agencies who wish to enhance their screening efforts for this important population.

The 9 promising practices described within this guide include: 

  1. Define a CRC Metric for State Medicaid Plans
  2. Support or Mandate Public Reporting of CRC Screening Rates
  3. Develop an Incentive Program/Value-Based Purchasing Measure for CRC
  4. Provide Education and Technical Support to Managed Care Organizations and Providers
  5. Collaborate with State Public Health Staff
  6. Work Closely with FQHCs that Serve Large Medicaid Populations
  7. Promote Evidence-Based Strategies and Interventions
  8. Facilitate Access by Covering Multiple Tests Without Cost-Sharing
  9. Promote Test Options to Overcome Compliance Barriers, Provider Shortages, Geographic Issues, and Logistical Constraints

Note: We are not able to share the webinar recording at this time since some of the presentations contain unpublished data, but we will post the recording to this webpage as soon as we have permission to do so. 

Webinar – What Do The Data Tell Us: What Can We Learn From The Latest Colorectal Cancer Screening Rate Trends Over Time? –  January 30, 2020

This webinar provided a look at the latest data that informs how we are doing as a nation with our efforts to reach an 80% colorectal cancer screening rate. The webinar included a review of the key colorectal cancer screening data sets: BRFSS, NHIS, HEDIS, and UDS. Participants heard from experts as they gave an update on where we are progressing and where we still need to focus, to help inform your work ahead. (Note: this webinar was a repeat of a panel that was hosted at the 2019 NCCRT Annual Meeting.)

Speakers:

  • Djenaba A. Joseph, MD, MPH, Medical Director, Colorectal Cancer Control Program, Centers for Disease Control and Prevention
  • Stacey Fedewa, Senior Principal Scientist, Surveillance Research, American Cancer Society, Inc.
  • Mary Barton, MD, MPP, Vice President, Performance Measurement, National Committee for Quality Assurance
  • Minh Nguyen, Pharm D, MPH, Public Health Analyst, Health Resources and Services Administration

The Dos and Don’ts of Colorectal Cancer Screening

This one-page flyer may be used to remind clinicians about some of the dos and don’ts when it comes to colorectal cancer screening.

Partners may have the option to cobrand the flyer with their organization’s logo. Contact your local American Cancer Society to learn more.

80% in Every Community 2019 Messaging Guidebook: Recommended Messages to Reaching the Unscreened – July 16, 2019

This webinar provided an introduction to the 2019 80% in Every Community Messaging Guidebook: Recommended messages to reach the unscreened. The guidebook serves as a resource to both better understand the motivations, attitudes, and barriers of key unscreened populations, while it also recommends market tested messages that can educate and motivate these key audiences on the importance of colorectal cancer screening. The 2019 update to this NCCRT resource includes new findings, new population profiles, and message delivery insights that will better inform our efforts to improve colorectal cancer screening rates to 80% in Every Community. 

Speakers:

  • Michelle Aubertine, KS&R
  • Bill Willard, American Cancer Society

 

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.”

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.

Exemplary Health Plan Practices

Exemplary Health Plan Practices – September 10, 2015

During this webinar, Andrew Zinkel, MD, MBA, Associate Medical Director of Quality at HealthPartners, an early supporter of the 80% by 2018 effort, shared HealthPartners’ experience with colorectal cancer screening efforts, including work they have done to use data to address disparities issues. Find additional guidance in the resource, Colorectal Cancer Screening Best Practices Handbook for Health Plans.

Speaker:

  • Andrew Zinkel, MD, MBA, HealthPartners

What Can Insurers Do To Advance 80% By 2018?

Learn how health insurers can be part of the national effort to make sure 80% of adults ages 50 and older are regularly screened for colorectal cancer by 2018.