Key Themes | Theme Identified by Health Plans | Sampling of Illustrative Quotes | |
---|---|---|---|
Ā | Collaborative Model | Centralized Model | Ā |
Program Design | |||
āFlexibility for each health plan to be either centralized or collaborative | X | X | ā[Program] allows more people to be identified and screenedā¦to really identify and get more people screened so we can move upstream any care that might be necessary for a member.ā ā Centralized āA lot of other metrics to move are ones where patients need to come in for a clinic visit and so [we] particularly like this strategy because it can be done outside of the clinicā¦and clinics were like, āwe donāt have to do anything and youāre going to help us get more patients screened? Great! And clinics would sign on because the [mailing] effort was coordinated at [health plan].ā ā Collaborative |
āAnother avenue to screen patients outside of a clinical visit/decreases patient burden | X | X | |
āPartnership approach/design encouraged health center participation by reducing staff burden and cost to implement CRC screening on own | X | Ā | |
āHealth centers involved in project had all used FIT previously | X | Ā | |
āEncouraging health centers to scrub or clean eligibility list prior to mailing to update screening or identify wrong address | X | Ā | |
Vendor Experience | |||
āDocumentation level from Vendor has been helpful | Ā | X | āWe had great success with follow-up calls to our members and getting them appointments for positive screenings and get them into the office ā that worked well.ā ā Centralized āWhat we learned with the ordering and processing of kits [with vendor] was a processā¦like just getting the workflow of the kits sent here directly to [health plan], instead of kind of being the middleman and just shuffling things around, and that seems to be working pretty good now.ā ā Collaborative |
āSuccess completing follow up calls and making appointments for members with abnormal result | Ā | X | |
āWorking through initial challenges to order and mail kits valuable | X | Ā | |
Engagement and Communication | |||
āFamiliarity with health centers and strong relationships | X | Ā | āThe provider groups were informed well in advance on the project and were happy with the informationā¦and another success is that we are getting more provider engagement around the intervention and understanding around what we are doing here in the quality department.ā ā Centralized ā[Health centers] are invested in it, they are committed to itā¦they spread it to their teams. They had meetings and explained the [program] ā they knew what was happeningā¦ we didnāt have any clinics take part that hadnāt already used FIT before in their clinics.ā ā Collaborative |
āStaff at health centers knew what was happening regarding the program / and took work personally to work hard and achieve goal | X | Ā | |
āProvider groups and their teams were engaged and informed of program | Ā | X | |
Reaction/Satisfaction of Stakeholders (provider /health center /patient) | |||
āPositive reactions from health centers and providers (e.g., no complaints) | X | X | āMembers were very appreciativeā¦We often donāt get a sense of member [satisfaction], but through this we were able to do a lot of member outreach after a possible positive result and actually speak to membersā¦who were telling us about their experiences of screening.ā ā Centralized āProviders are very grateful that this is just another way that we can tap into getting them in for screeningā¦and the resources required at clinic level were so low ā itās when the FIT comes back in where most of clinic resources are and they already staff that generally ā so running the program at the clinic level was low enough that clinics werenāt saying they couldnāt staff it.ā ā Collaborative |
āPositive reaction from patients (e.g., no complaints)/expressions of appreciation | X | X | |
āSome patients called in to share they had their colonoscopy or FIT completed | X | X | |
āPatients were appreciative of follow-up call after abnormal FIT result | Ā | X | |
āHealth centers that participated experienced minimum time and staff burden | X | Ā | |
Processing/Returning of Mailed Kits | |||
āResults intriguing enough to continue program for second year | X | X | āWe are really pleased to see how many of our Medicaid members that we included in the intervention actually complete a kit. Weāre usually very excited if we can get a very small percentage of our members to participate in an intervention that we target them forā¦. And then with our Medicare population we had an [increase] of members complete the kits ā so we are very excited about the outcomes that we did receive.ā ā Centralized āWe are pleased with the partnership model showing successā¦actively sending out kits to members through the BeneFIT program, you can actually see [clinic] numbers are incredibly higher. For some itās almost doubled from what they were normally doing.ā ā Collaborative |
āAct of trying it for the first year a success in and of itself: establish workflows and address challenges as move into second year | X | X | |
āAccess to follow-up colonoscopy for abnormal results going well | X | X | |
āMore members are being screened for CRC with mail out program than previously | X | X | |
āReturn rates for Medicare and Medicaid members better than in past mailed efforts and seems promising | Ā | X | |
āCRC screening rates were higher in many health centers participating in program and improved from prior years | X | Ā | |
Leadership Support | |||
āSupport and strong champion to lead program at health plan level | X | X | āIt was helpful to have leadership buy-in from the beginning ā to have [multiple health plan] leaders a part of the process early on and heavily involved at the very beginning ā thatās important for operating any large intervention.ā ā Centralized ā[Health plan] has been sold on this project from the beginningā¦and there is also medical collaboration too. Medical directors have been meeting with provider groups and giving presentations on the importance of FIT as a method of screening.ā ā Collaborative |
āMedical directors at health centers promoting FIT and idea of mailed FIT | X | Ā | |
Compatibility with Health Plan | |||
āMatches well with organizationās mission and goals | X | X | āFrom a program perspective I think it gets to what is needed and necessary for improving access to the tests and for more testing to be completed ā so as a program it runs well.ā ā Centralized āThis whole approach of collaborationā¦is another big driving factor for thisā¦ [Health plan] has a really strong ethos of working with clinics to help their patients get healthier and to push out preventive careā¦[and] is known for working with their clinics in creative ways.ā ā Collaborative |
āProject housed within group that measures how clinics/providers are doing on quality metrics, including CRC screening | X | X | |
āOrganization known for working with their health centers in supportive and partnering ways | X | Ā | |
Broader Impacts | |||
āProgram helps to increase patient engagement with their provider, the health plan, and their own health | X | X | āIt really did invigorate our member outreachā¦it has helped us with thinking about other outreach to members that might be successful.ā ā Centralized āThis shows a path to improve colorectal cancer screening which is critical in and of itself. But importantly, what itās saying is here is a model of how you can go about doing things ā a model for expanding into other things outside of colorectal cancer screening.ā ā Collaborative |
āIncreased general awareness of providers and other staff regarding activities in the health plansā quality program departments, and specific awareness about mailed FIT programs | X | X | |
āProvides a roadmap for addressing population health efforts via mail out programs for other care gap areas | X | X | |
Collaboration/Resources from Researchers | |||
āHelpful for health plans to learn from research staff, and learn how other plan is implementing the mailed FIT program (materials, design and delivery, etc.) | X | X | āOne reason we like this so much is because there is a really important part of having [the researchers]and all the information and data thatās being collected and presented to then inform beyond colorectal cancer screening.ā ā Collaborative āThat partnership and seeing what others have done successfully in the field helped us improve our interventionā¦and it was really nice to include the [wordless instructions] with the kitā¦for those members who might have had a difficult time readingā¦ā ā Centralized |
āAbility to use wordless instructions developed by researchers for previous project | Ā | X |