Health Policy to Promote Colorectal Cancer Screening: Improving Access and Aligning Federal and State Incentives

Area of Science:

• Public Health
• Health Services Research
• Health Policy

Background:

• The Affordable Care Act expanded Medicaid coverage to millions.
• Colorectal cancer (CRC) screening is crucial for early detection.
• Historically underserved populations often have lower screening rates.

Purpose of the Study:

• To evaluate the impact of including CRC screening as a quality metric in Oregon's pay-for-performance Medicaid program.
• To assess changes in CRC screening rates among Medicaid enrollees post-expansion.
• To gauge stakeholder perceptions on incentivizing CRC screening.

Main Methods:

• Analysis of Oregon Health Authority data on Medicaid enrollees eligible for CRC screening.
• Comparison of CRC screening rates in 2011 and 2013.
• Survey of stakeholders regarding CRC screening incentives.

Main Results:

• The Medicaid-eligible population for CRC screening grew by 55% between late 2013 and mid-2014.
• CRC screening rates improved by over 3% for 40% of coordinated care organizations (CCOs) between 2011 and 2013.
• 70% of surveyed stakeholders supported the CRC screening metric.

Conclusions:

• Integrating CRC screening into Medicaid quality metrics can increase screening rates in underserved populations.
• Pay-for-performance programs show promise in improving cancer screening uptake.
• Stakeholder support is vital for successful implementation of health initiatives.