Breast Cancer Screening Staff Incentive Program

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1 Breast Cancer Screening Staff Incentive Program September 19, 2017 Presenters: PHC QI Staff Joy Dionisio, MPH PHC Project Coordinator II Mark Netherda, MD PHC Regional Medical Director Petaluma Health Center Staff Tiffany Jimenez, RN, MSN QI and Care Innovations Director Karen Page, MA Women s Health Care Coordinator

2 To avoid echoes and feedback, we request that you use the telephone instead of your computer microphone for listening/talking during the webinar. Audio Instructions

3 Objectives Understand new measure Share Partnership performance data Share best practices Staff Incentive Program Next steps Questions

4 Background Breast Cancer Statistics Leading cause of premature mortality among US women After skin cancer, most common cancer in women; after lung cancer, the leading cause of cancer related deaths* 1 in 8 (12%) U.S. women (who live 80 years) will get breast cancer 252,710 cases in 2017 in women (2,740 in men) 40,610 deaths estimated for 2017 Risks include: Genetics family history and certain genetic variants Weight/diet being overweight and consuming a high fat diet Alcohol women who drink regularly are at higher risk Smoking small increase in breast cancer risk Estrogen prolonged exposure (no pregnancies, no breast feeding, hormone replacement) *Breast Cancer is leading cause of cancer related deaths in Hispanic women

5 Background Mammography Statistics Associated with reduced breast cancer illness and deaths Risk changes by age group no change in risk of death, 0-9 deaths avoided for every 10,000 women screened for 10 years % lower risk of death, 2-17/10,000 deaths avoided % lower risk of death, 11-32/10,000 deaths avoided Earlier detection improves risk of treatment False positives = unnecessary testing and biopsies false positives/10,000 mammograms ~170 unnecessary biopsies/ 10,000 mammograms False negatives = missed cancer 10-13/10,000 mammograms

PHC Priority PHC s transportation benefit New benefit Members to use the number on wneb page to schedule appointments through MTM (1-888-828-1254 M-F 8-5) Mammography services In the process of

6 PHC Priority PHC s transportation benefit New benefit Members to use the number on wneb page to schedule appointments through MTM ( M-F 8-5) Mammography services In the process of compiling a comprehensive list Mobile Mammography Looking into this possibility to improve access May be able to combine with other insurers to make mammography available more locally for rural areas

7 Breast Cancer Screening Denominator: The number of women years of age as of December 31, (DOB January 1, 1943 and December 31, 1965). Numerator: The number of eligible population in the denominator with one or more mammograms any time on or between October 1, 2015 and December 31, 2017.

8 Breast Cancer Screening Exclusions (only if not numerator compliant): Bilateral mastectomy any time during the member s history through December 31, Any of the following meet criteria for bilateral mastectomy: Bilateral mastectomy Unilateral mastectomy with a bilateral modifier Two unilateral mastectomy with service dates 14 days or more apart History of bilateral mastectomy Any combination of codes that indicate a mastectomy on both the left and right side on the same or different dates of service

9 Breast Cancer Screening Added to 2018 Internal and Family Medicine QIP Measurement Sets Measure Description: Percentage of continuously enrolled Medi-Cal women years of age who had a mammogram to screen for breast cancer

13 Breast Cancer Screening Webinar September 19 th, 2017 Tiffany Jimenez, RN, MSN Quality Improvement and Care Innovations Director Karen Page, MA Women s Health Care Coordinator

14 Breast Cancer Screening Webinar September 19 th, 2017 Tiffany Jimenez, RN, MSN Quality Improvement and Care Innovations Director Karen Page, MA Women s Health Care Coordinator

About PHC/RPHC Federally Qualified Health Center (FQHC) Two locations in Southern Sonoma County Petaluma Health Center Rohnert Park Health Center Family Practice with

15 About PHC/RPHC Federally Qualified Health Center (FQHC) Two locations in Southern Sonoma County Petaluma Health Center Rohnert Park Health Center Family Practice with 28,000 unique patients in 2 locations Approximately 50% of patients have Partnership Primary care with on site Dental, OB/GYN, MH services, Nutrition, and Integrative Medicine

16 Performance

17 Strategies that work Covering Costs of Breast CA Screening

18 Strategies that Work Huddle & Alerts

19 Strategies that Work Automated Recalls for patients years, due for mammogram

20 Strategies that Work Direct Scheduling for Mammograms Patient Reminder Cards

21 Strategies that Work Monitor Access & Appointment Scheduling

22 Challenges / Lessons Learned Management of the Mammo Schedule Division of Responsibilities FO imaging tasks No-shows Staff training: mammo orders & required info Guideline change for mammograms

23 What s Next Increased access to mammo appointments Additional MA training in health coaching Additional patient outreach New patient intake process Continue to monitor

24 Questions? Comments?

25 CONTACT INFORMATION Tiffany Jimenez, RN, MSN Quality Improvement & Care Innovations Director Petaluma Health Center

26 Staff Incentive Programs Recognize the front-line and critical staff Last year s program: (MPM) Annual Monitoring Patients on Persistent Medications Reward provider sites with outstanding performance ACEs or ARBS and Diuretics two rates reported separately 86 sites participate Performance improved in all 4 regions for ACE/ARB; 2 regions improved for Diuretics Denominator List

27 Breast Cancer Screening Staff Incentive Program Minimum 100 assigned PHC adult members Enrollment in the program by October 6, 2017 $11 per member for full incentive $5.5 per member for partial incentive Outstanding Performance (Full Incentive) Outstanding Improvement (Partial Incentive) Target Details 71.5% This target is based on the BCS performance percentiles obtained from HEDIS 2017 national averages for Medicaid HMO plans. 25% relative (Current Performance Baseline improvement Performance) / (100-Baseline) Current Performance: 2017 BCS Score Baseline Performance: 2016 BCS Score

28 Understand Your Current State Baseline data report Learn how you performed on this measure during calendar year 2016, compared to national MPL, QIP targets, and your peer health centers. Explore your system gaps Research members that were non-compliant in Is there a pattern?

29 Next Steps Sign up for the program by October 6, The following data reports will be sent to enrollees Comparative Data Report (Your performance compared to PHC providers in your region) Patient Outreach List (Patients who are due for lab testing before December 31, 2017) For any other concerns or inquiries, us at

30 Questions?

QIP/HEDIS Measure Webinar Series

QIP/HEDIS Measure Webinar Series September 26, 2017 Presenters: Partnership HealthPlan Quality Department Partnership HealthPlan of California To avoid echoes and feedback, we request that you use the