80% 80% b by 201 2018 Reso esources Color Colorectal l Ca - - PowerPoint PPT Presentation

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80% 80% b by 201 2018 Reso esources Color Colorectal l Ca Canc ncer Roundt Roundtabl ble Ric Richm hmond nd, V VA Marc

rch h 17 17th

th, 201

2016

Andy Cobb, American Cancer Society

What is the NCCRT mission?

• The National Colorectal Cancer Roundtable (NCCRT) is a

national coalition of public, private, and voluntary organizations whose mission is to advance colorectal cancer control efforts by improving communication, coordination, and collaboration among health agencies, medical-professional organizations, and the public.

• The ultimate goal of the Roundtable is to increase the use of

proven colorectal cancer screening tests among the entire population for whom screening is appropriate.

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Tools, Resources, Publications

nccrt.org/tools

Tools

• Launched with a major event at the National Press Club
• Featured numerous national leaders and partners in the 80%

by 2018 effort

• Coincided with data showing that CRC death rates had

dropped 30% in the last decade

2014: Launch of 80% by 2018

More and More Organizations Are Signing the Pledge

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What is it going to take to get to 80%? Maintaining Momentum …

Four Strategic Plan Goals to Achieve 80% by 2018

Consumers Move consumers to action Systems Use providers, payers, and employers to support screening Policy Increase access and remove barriers to screening Process Maintain momentum

Profiles of priority audiences and tested messages nccrt.org/80by2018

Barriers to Screening – 2014 Market Research

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• Unscreened have lower income than screened counterparts
• More likely to be uninsured
• Newly insured don’t know it’s covered

Affordability

• Symptoms drive doctor visits
• Misconception about disease

Lack of symptoms

• Perception that heredity is only risk factor
• Reduced sense of urgency

No family history

• Focus on acute illnesses and issues of more concern
• Not a top priority
• No personal connection to cancer

More pressing health issues

• Connotation of test being unpleasant, invasive, embarrassing
• Fear of test-prep compounds negativity

Negative perceptions about the test

• Utilize medical neighborhood
• Avoids doctors/no routine physicals or wellness visits
• Think they’re healthy already

No regular primary care to reinforce message

• #1 reason among African Americans
• #3 reason among Hispanics

Doctor does not recommend it

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Newly insured Rationalizer/procrastinator Economically disadvantaged

Hispanic (53% screening rate) African American Caucasian Asian American/Pacific Islander Native American/Alaska Native

Priority Audiences

Key Messages

There are several screening options available, including simple take home options. Talk to your doctor about getting screened. Colon cancer is the second leading cause of cancer death in the US, when men and women are combined, yet it can be prevented or detected at an early stage. Preventing colon cancer or finding it early doesn’t have to be

• expensive. There are simple, affordable tests available. Get

screened! Call your doctor today.

Fight Colorectal Cancer Fight Colorectal Cancer

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New! Hispanics and Colorectal Cancer Companion Guide

• -Perceptions
• -Barriers
• -Recommendations
• -Tested Messages
• -Sample Collateral

nccrt.org/tools/80-percent-by-2018/hispanics-latinos-companion-guide/

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Reaching the Unscreened Shaping Dialogue, Engaging Supporters

Advocacy Groups & State/Federal Agencies & CCC Medical Home or Neighborhood Media (paid & earned) Caregivers, Families & Friends Payers & Employers Community & Cultural Touch points

• Reinforce messages about importance of

screening, alleviate fear, and make the need real

• Online appointment scheduling and

reminders

• Distribute Q&A’s, brochures, posters

through DTC channels

• Promote 80% by 2018
• Lend credibility to local efforts
• Underscore disease burden with

data

• Engage spokespersons
• Seek media partnerships
• PSAs
• Editorial calendar
• Complement with digital
• Develop cache of

survivor stories & spokespeople

• Co-promote assets
• Light up social media
• Share ACA materials
• “80% by 2018” and NCCRT

member communications

• Tap into benefits exchanges &

vendors

• Align with Human Resources depts.
• Disseminate employee-centric

collateral

• Work with payers on incentives
• Partner with neighborhood organizations
• In-market activities such as walk/runs,

fundraising events

• Leverage local dignitaries/leaders as

spokespersons

• Churches strategy for Hispanic and AA

comunities

Consumer

• Partner with primary care
• NCCRT member communications
• Outreach to Promotores
• Align with FQHCs
• Expand Flu-FIT program

nccrt.org/80by2018

Systems Change

Working with Primary Care Practices

What’s worked?

• Keeping providers informed of their screening rates as compared to HP

goals and their peers

• Using community health workers/patient navigators to navigate patients

through the screening process

• Using EHRs to improve the referral and reminder process through

automation

• Developing better lines of communication with gastroenterologists
• Creating learning communities that PCPs can share best practices for

increased CRC rates

• Delivering messaging and tools related to CRC screening through quality

improvement organizations and initiatives

• Working through state CCC plans, ACS and state department of health to

reach primary care

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http://nccrt.org/about/provider-education/manual-for-community-health-centers-2/

Community Health Center Manual on CRC Screening

Step #1 Make A Plan

Determine Baseline Screening Rates

• Identify your

patients due for screening

• Identify patients

who received screening

• Calculate the

baseline screening rate

• Improve the

accuracy of the baseline screening rate Design Your Practice's Screening Strategy

• Choose a

screening method

• Use a high

sensitivity stool- based test

• Understand

insurance complexities.

• Calculate the

clinic's need for colonoscopy

• Consider a direct

endoscopy referral system

Step #2 Assemble A Team

Form An Internal CHC Leadership Team

• Identify an

internal champion

• Define roles of

internal champions

• Utilize patient

navigators

• Define roles of

patient navigators

• Agree on team

tasks Partner with Colonoscopists

• Identify a

physician champion

Step #3 Get Patients Screened

Prepare The Clinic

• Conduct a risk

assessment Prepare The Patient

• Provide patient

education materials Make A Recommendation

• Convince

reluctant patients to get screened Ensure Quality Screening for Stool- Based Screening Program Track Return Rates and Follow-Up Measure and Improve Performance

Step #4 Coordinate Care Across The Continuum

Coordinate Follow-Up After Colonoscopy

• Establish a

medical neighborhood

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EHR Best Practices Workflow Guide: eClinicalWorks

Guidance on:

• -Documenting family history
• -How and where to enter
• rders
• -Generating referrals
• -Entering test results
• -Creating insurance claims

Working with Payers

What’s worked?

• Work on CRC awareness/reminders
• Targeted screening reminders for both patients and physicians
• Using data to identify and target subpopulations
• Encouraging testing through health plan sponsored worksite wellness programs
• Using quality measures to incentivize screening
• Patience and perseverance and a friend on the inside (copay removal)
• Some collaboration with state Medicaid programs
• Lobbying states to make CRC screening a required performance measure
• Working with state insurance commissioner to formally communicate to

plans that there is no cost sharing for polyp removal

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Exemplary Health Plan Practices 80% by 2018 “Mini” Webinar Series

September 10th, 2015 1:00pm EST

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Tools for Insurers, Hospitals

Working with Hospital Systems

What’s worked?

• Taking steps to align effort w/ hospital values and resources

(www.hpoe.org/cultureofhealth)

• Alignment: To what degree are your organization’s mission, vision and values

aligned with effort?

• Leadership engagement: Do you have a passionate institutional champion?
• Resources: What resources can your organization commit?
• Influence: What is your organization’s level of influence in the community?
• Leverage the hospital system’s role as a respected health leader to

promote and advocate for screening

• Prioritize delivery and care coordination of quality CRC screening across

the continuum, including for employees

• Be a leader in establishing partnerships with other stakeholders,

particularly primary care

• Lead the effort to improve access to screening for the underserved

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Public Website with Sample Program Materials: http://flufobt.org

Links of Care Pilots

Primary goal:

• Increase timely access

to specialists for FQHC patients after a positive colorectal cancer screening result. Key characteristics:

• Physician champion
• Shared burden
• Care coordination/

documented workflows

• Screening navigation
• Shared credit

Employer Challenge Toolkit

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New Tools Now Available

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Advocacy Tools

New resources coming soon!

Guide to the Development of State Level CRC Coalitions (Roundtables) 2016

• Grand Prize: Coal Country Community Health Centers
• f North Dakota (Community Health Center)
• Honorees:
• Phoebe Putney Health System of Georgia (Hospital)
• Tina Kiser Cancer Concern Coalition of Ohio

(Coalition/Roundtable)

• Premier Medical Associates of Pennsylvania (Physician

Practice)

• South Carolina Public Employee Benefit Authority (Health

Plan) Learn more: nccrt.org/tools/80-by-2018-2016-awardees/

80% by 2018 National Achievement Awards

The Year of Success

Questions/Discussion andrew.cobb@cancer.org nccrt.org