Best Chance Network. SCDHEC & SCORH: Involving Your Clinic to Provide Access. Stephanie Hinton, MA, MHS, CPM

Transcription

1 Best Chance Network SCDHEC & SCORH: Involving Your Clinic to Provide Access Stephanie Hinton, MA, MHS, CPM

2 Objectives Ove rview of the SC ORH /SC DHEC Ca n ce r Division Pa rtn e rship Program updates-what s New Coordinating with ORH practices New Data

3 A Data Driven Identified Need Partnership Background: SCDHEC & SCORH Why the partnership: Data review identified Critical Need to expand program partnerships to: address identified gaps at population health levels within the state, p articu larly in ru ral are as. Review of program data and provider needs identified Critical Need to increase technical assistance to providers and build capacity at practice population health levels to: increase preventative cancer and cardiovascular risk screening and d iagn ose, follow-up and treat for these diseases to reduce mortality; ensure preventative, diagnostic and follow-u p service d e live ry to all program eligible patients and non-e ligib le p atie n ts.

4 Partnership Em phasis Fram ew ork Enhanced delivery of Cancer program services for providers and patients; Increasing/maximizing access points in regions and counties within state; Deliberate Concentration Placed On Low screening rates and rescreening rates High incidence and mortality rates Cardiovascular disease prevalence and risk Identification of under-performing rural providers Disparate populations and navigation into screening and care

5 Identifying our Collaboration Reviewed ORH organizational profile and services Planning meeting to identify common goals Reviewed relevant data, service areas and BCN/WW providers within the ORH network

6 SCDHEC Cancer Division Program s & SCORH Partnership Purpose Improve Patient Health Outcomes at Population Level Provide Contracted Providers Within ORH Network Targeted support Intensive onsite, hands-on technical assistance through Quality Improvement Coaches Improve Patient Health Outcomes for Cancer and CVD Enhancing/Build Provider Capacity to increase statewide population health level via; Breast, cervical and cardiovascular disease (CVD) screenings/rescreenings and participation in preventative lifestyle health coaching through the BCN and WW programs

7 SCDHEC Cancer Division Program s & SCORH Partnership Focu s Particular efforts are made to reach women in rural regions of the state with low screening rates and/or high incidence and mortality rates, and/or lowperforming BCN/WW providers. Selected Activities Include providing: Population health coaching strategies, program implementation and improvement guidance; practice transformation and implementation of evidence based interventions; Relevant training opportunities through webinars and technical assistance to assist providers in the delivery of services and program im p le m e n tation ; Support to local Rural Health Networks to provide community assistance into preventative screening and diagnostic services.

8 Best Chance Network Program : What s New New 5 year Cooperative Agreement with CDC DP ( )---New areas of em phasis include: Preventative population health level breast and cervical cancer screening for BCN and non-bcn eligible women with clearly defined outcomes; Extension of patient navigation services into preventative screening in addition to diagnostic and follow-up patient navigation services Health Resources and Services Administration (HERSA )& Center for Disease Control (CDC) working together to ensure that population health level breast and cervical cancer preventative screening, diagnostic and follow-up services are provided with emphasis on FQHC s

9 Best Chance Network Program : What s New New 5 year Cooperative Agreement with CDC DP ( )---New areas of em phasis include: Eligibility Changes- At or below 250% of the federal poverty level Ages 30 to 64 are eligible breast cancer screening; symptomatic or family history Ages <29 eligible only for breast diagnostic services Ages 21 to 64 are eligible cervical cancer screening Uninsured, Underinsured, Part A Hospital coverage online; in a high deductible health plan or diagnostic services not covered. (payer of last resort)

10 WISEWOMAN Program : What s New Expansion and emphasis on completion of preventative cardiovascular screening and rescreening services; Expansion of access via increase of new providers across state; Focus on increasing health coaching completion rates and types of health coaching opportunities available to providers and eligible patients

11 Involving Your Clinic to Provide Access Redesigning how cancer and cardiovascular screening services are coordinated and delivered to ensure: Health care practices are supported to operate at a population health level for cancer and cardiovascular risk prevention, early detection and control and; Incorporation of effective strategies for delivery of services as a team approach: Working through using EMR/EHR to identify all eligible women Reduce structural barriers Increase preventative screenings Engage community

12 Involving Your Clinic to Provide Access Increase health coaching and lifestyle interventions Weight management Healthy Eating and Active Living Addressing abnormal blood pressures and A1C Maximizing effectiveness of Care Increasing access/availability of care are part of Healthcare Effectiveness Data and Information Set (HEDIS) eight domains of care. HEDIS Measures

13 PCM H Standard 2, Element D: Factors 3, 4, 5, 6, 7, 9 Standard 3, Element C: Factors 1, 2, 4 Element D: Factors 1, 4 Elem ent E: Factor 5 Standard 4, Element A: Factor 5 Element E: Factors 2, 3, 4, 5, 6 & 7

14 Meaningful Use - Clinical Quality Measures (NQF 0419)Closing the referral loop (NQF 0032)Cervical Cancer Screening (NQF 0031)Breast Cancer Screening (NQF 0033) Chlamydia Screening for Women

15 HEDIS Adults Access to Preventive Care Adult BMI Cholesterol Management Breast Cancer Screening Cervical Cancer Screening Chlamydia Screening

16 Understanding Sou th Ca rolin a s Sp e cific n e e d s t h ro u g h s t a t e le ve l DATA!!!

17 WISEWOMAN Need Diabetes in SC

18 WISEWOMAN Need Hypertension in South Carolina

19 Breast Cancer Early vs. Late Stage Com parison For US, SC, & Regions, for all ages, an d BCN-Eligible Age Group, Early & late stage female breast cancer, all ages Early & late stage female breast cancer, years early late early late National 72.1% 27.9% National 70.0% 30.0% South Carolina 70.4% 29.6% South Carolina 67.1% 32.9% Upstate 74.1% 25.9% Upstate 71.9% 28.1% Midlands 67.1% 32.9% Midlands 63.8% 36.2% Low Country 71.2% 28.8% Low Country 66.9% 33.1% Pee Dee 67.5% 32.5% Pee Dee 63.8% 36.2%

20 Female Breast Cancer Incidence Rates by DHEC Regions, All Races,

21 Female Breast Cancer Incidence Rates by DHEC Regions, All Races,

22 Breast cancer incidence rate for DHEC regions by race, Rat e per 100,000 fem ales South Carolina Upstate Midlands Low Country Pee Dee All races White Black

23 Female Breast Cancer Mortality Rates by DHEC Regions, All Races,

24 Female Breast Cancer Mortality Rates by DHEC Regions, All Races,

25 Breast cancer mortality rate for DHEC regions by race, Rat e per 100,000 fem ales South Carolina Upstate Midlands Low Country Pee Dee All races White Black

26 Female Breast cancer incidence, year olds, Female Breast cancer incidence, all ages, Rate Rate South Carolina South Carolina Upstate Upstate Midlands Midlands Low Country Low Country Pee Dee Pee Dee Focusing on the BCN-Eligible Age-group for Comparison

27 Cervical Cancer Incidence, SC and DHEC Regions, all races, Cervical cancer incidence Rate Count South Carolina Upstate Midlands Low Country Pee Dee Rat e per 100,000 fem ales Cervical cancer incidence for all races, South Carolina Upstate Midlands Low Country Pee Dee

28 Cervical Cancer Incidence Rates by DHEC Regions, All Races,

29 Cervical Cancer Incidence Rates by DHEC Regions, All Races,

30 Cervical cancer incidence rat e for DHEC regions by race, Rat e per 100,000 fem ales South Carolina Upstate Midlands Low Country Pee Dee All races White Black BLACKS - HIGHER RATES THAN WHITES IN ALL REGIONS

31 Cervical Cancer Mortality, SC and DHEC Regions, all races, Cervical cancer mortality rates for DHEC regions, Cervical cancer deaths, Rate Count South Carolina Upstate Midlands Low Country Pee Dee Rat e per 100,000 fem ales South Carolina Upstate Midlands Low Country Pee Dee

32 Cervical Cancer Mortality Rates by DHEC Regions, All Races,

33 Cervical Cancer Mortality Rates by DHEC Regions, All Races,

34 Cervical Cancer Early vs. Late Stage Com parison SC and DHEC Regions and the US, for all ages, an d BCN-Eligible Age Group, Early & late stage cervical cancer, all ages Early & late stage cervical cancer, years early late early late National 46.0% 54.0% National 48.5% 51.5% South Carolina 43.1% 56.9% South Carolina 43.9% 56.1% Upstate 44.1% 55.9% Upstate 44.7% 55.3% Midlands 42.2% 57.8% Midlands 42.9% 57.1% Low Country 48.3% 51.7% Low Country 47.4% 52.6% Pee Dee 36.6% 63.4% Pee Dee 39.7% 60.3% HALF OF ALL CERVICAL CANCER IN U.S., S.C., AND ALL REGIONS IS DIAGNOSED AT ADVANCED STAGE

35 Cervical cancer mortality rate for DHEC regions by race, Rat e per 100,000 fem ales South Carolina Upstate Midlands Low Country Pee Dee All races White Black Black women have higher rates of cervical cancer deaths in each DHEC Region

36 Incidence All Cancer National Rank dropped from 28 th to 32 nd Chester County highest county Upstate highest region Breast National rank increased to 19 th from 20 th McCormick highest county Low Country highest region Cervi cal National rank decreased from 20 th to 15 th Pee Dee highest region In Summary

37 Mortality All Cancer National rank remained 14 th Lee County highest county Pee Dee highest region Breast National rank increased from 14 th to 8 th Williamsburg highest county Midlands highest region Cervi cal National rank decreased from 15 th to 12 th Pee Dee highest region

38 Racial Disparities Bla ck-to-wh ite Com parison for Incidence Breast Cancer In SC White incidence rate is 1.4% higher than that of Blacks In Upstate White incidence rate is 6.1% higher than that of Blacks Breast Cancer In SC White incidence rate is 2.2% higher than that of Blacks However, in Midlands: Blacks 4.8% higher

39 Breast cancer: Racial Disparities Bla ck-to-wh ite Com parison for Mortality In SC Black death rate 44% higher than that of Whites In Upstate Black death rate 49% higher than that of Whites Breast cancer: In SC Black death rate 42% higher than that of Whites In Midlands Black death rate 49% higher than that of Whites

40 Racial Disparities Bla ck-to-wh ite Com parison for Incidence Cervi cal Can cer In SC Black incidence rate is 15% higher than that of Whites In Upstate Black incidence is 14.5% higher than that of Whites Cervi cal Can cer In SC Black incidence rate is 19% higher than that of Whites--An increase of 5%! In Pee Dee - Black incidence rate is 35.9% higher than that of Whites

41 Racial Disparities Bla ck-to-wh ite Com parison for Mortality Cervi cal Can cer: In SC - Black death rate nearly double that of Whites In Upstate - Black death rate 104% higher than that of Whites Cervi cal Can cer: In SC - Black death rate nearly double (95% higher) that of Whites In Pee Dee - Black death rate 230% higher than that of Whites

42 Eligible Population in South Ca rolin a Based on 250% of the Federal Poverty Level Cervical Estimate for Ages 21 to 64 = 156,817 Breast Estimate for Ages 30 to 64 = 114,749 WISEWOMAN Estimate for Ages 40 to 64 = 74,827 Based on Small Area Insurance Estimate (SAHIE)

43 Quest ions!

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