80% 80% b by 201 2018 Reso esources Color Colorectal l Ca Canc ncer Roundt Roundtabl ble Richm Ric hmond nd, V VA Marc rch h 17 17 th th , 201 2016 Andy Cobb, American Cancer Society 1
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.
nccrt.org/tools Tools, Resources, Publications 3
2014: Launch of 80% by 2018 • 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
More and More Organizations Are Signing the Pledge
Maintaining Momentum … What is it going to take to get to 80%? 6
Four Strategic Plan Goals to Achieve 80% by 2018 Systems Consumers Use providers, payers, and Move consumers to action employers to support screening Policy Process Increase access and Maintain momentum remove barriers to screening
Profiles of priority audiences and tested messages nccrt.org/80by2018
Barriers to Screening – 2014 Market Research • Unscreened have lower income than screened counterparts Affordability • More likely to be uninsured • Newly insured don’t know it’s covered • Symptoms drive doctor visits Lack of symptoms • Misconception about disease • Perception that heredity is only risk factor No family history • Reduced sense of urgency • Focus on acute illnesses and issues of more concern More pressing health • Not a top priority issues • No personal connection to cancer Negative perceptions • Connotation of test being unpleasant, invasive, embarrassing about the test • Fear of test-prep compounds negativity • Utilize medical neighborhood No regular primary care • Avoids doctors/no routine physicals or wellness visits to reinforce message • Think they’re healthy already Doctor does not • #1 reason among African Americans recommend it • #3 reason among Hispanics 9
Priority Audiences Newly insured Rationalizer/procrastinator Economically disadvantaged Hispanic (53% screening rate) African American Caucasian Asian American/Pacific Islander Native American/Alaska Native 10
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
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/ 13
Reaching the Unscreened Shaping Dialogue, Engaging Supporters • Reinforce messages about importance of • Partner with primary care screening, alleviate fear, and make the • NCCRT member communications need real • Outreach to Promotores Online appointment scheduling and • • Align with FQHCs reminders • Expand Flu-FIT program Caregivers, • Distribute Q&A’s, brochures, posters Medical Home or Families & through DTC channels Neighborhood Friends • Promote 80% by 2018 • Lend credibility to local efforts • Underscore disease burden with • Develop cache of data survivor stories & Advocacy Groups & • Engage spokespersons spokespeople Media State/Federal • Seek media partnerships • Co-promote assets (paid & earned) Consumer Agencies & CCC • PSAs Light up social media • • Editorial calendar • Share ACA materials • Complement with digital Community & Payers & Employers Cultural Touch points • “80% by 2018” and NCCRT Partner with neighborhood organizations • member communications • In-market activities such as walk/runs, • Tap into benefits exchanges & fundraising events vendors • Leverage local dignitaries/leaders as • Align with Human Resources depts. spokespersons • Disseminate employee-centric Churches strategy for Hispanic and AA • collateral comunities • Work with payers on incentives 14
Systems Change nccrt.org/80by2018
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 16
Community Health Center Manual on CRC Screening http://nccrt.org/about/provider-education/manual-for-community-health-centers-2/
Step #4 Coordinate Step #2 Assemble A Step #3 Get Step #1 Make A Plan Care Across The Team Patients Screened Continuum Determine Baseline Form An Internal Prepare The Clinic Coordinate Screening Rates CHC Leadership • Conduct a risk Follow-Up After Team assessment • Identify your Colonoscopy patients due for • Identify an • Establish a Prepare The Patient screening internal champion medical • Provide patient • Define roles of neighborhood • Identify patients education internal who received materials champions screening • Utilize patient • Calculate the navigators Make A baseline screening • Define roles of Recommendation rate patient navigators • Convince • Improve the • Agree on team accuracy of the reluctant patients tasks baseline screening to get screened rate Partner with Ensure Quality Colonoscopists Design Your Screening for Stool- Practice's Screening • Identify a Based Screening Strategy physician Program champion • Choose a screening method Track Return Rates • Use a high and Follow-Up sensitivity stool- based test Measure and • Understand Improve insurance Performance complexities. • Calculate the clinic's need for colonoscopy • Consider a direct endoscopy referral 18 system
EHR Best Practices Workflow Guide: eClinicalWorks Guidance on: --Documenting family history --How and where to enter orders --Generating referrals --Entering test results --Creating insurance claims 19
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 20
Exemplary Health Plan Practices 80% by 2018 “Mini” Webinar Series September 10th, 2015 1:00pm EST
Tools for Insurers, Hospitals 22
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 23 • Lead the effort to improve access to screening for the underserved
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
New Tools Now Available 27
Advocacy Tools 28
New resources coming soon! Guide to the Development of State Level CRC Coalitions (Roundtables) 2016
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