Table 5 NE-DHHS: description of integrated payment model, screening outcomes, and cost by year
FY2017 (7/1/2016–6/30/2017) | FY2018 (7/1/2017–6/30/2018) | FY2019 (7/1/2018–6/30/2019) | FY2020 (7/1/2019–6/302020) | |
|---|---|---|---|---|
Description of integrated payment model | ||||
Contract | Fee-for-dervice | Fixed cost subaward | Fixed cost subaward | Fixed cost subaward |
FIT kit distribution and navigation payment for colorectal cancer screenings | Payment per service; % paid for kit return | Fixed fees for FIT kit distribution and kit returned | ||
Identification and navigation payment for breast and cervical cancer screening | Payment per service | Capped at $208 per person navigated | ||
Payment for meeting targets (separate payments for colorectal and breast/cervical cancer screenings) | None | Pay for performancea | ||
Administrative cost (across all cancer screenings) | 25% of total | Eliminated | ||
Strategic planning and quality improvement fee (across all cancer screenings) | $2000 per quarter | |||
Integration across programs | Administrative cost | Pay-for-performance approach | ||
Local health department (LHD) implementing partners | ||||
Number of local health departments participating in the program | 19 | 19 | 14 | 13 |
Screening outcomes | ||||
Colorectal cancer | ||||
FOBT kit distribution | 4101 | 3418 | 2308 | 1201 |
Kits returned (individuals screened) | 2162 | 1867 | 1037 | 703 |
Return rates (%) | 52.7 | 54.6 | 44.9 | 58.5 |
Breast and cervical cancers | ||||
Flagged | 1590 | 866 | 356 | 374 |
Navigated | 301 | 292 | 283 | 291 |
Screened | 198 | 265 | 262 | 277 |
% screened screened/reach | 12.5% | 30.6% | 73.6% | 74.1% |
% screened screened/navigated | 65.8% | 90.8% | 92.6% | 95.2% |
Costb | ||||
Cost per person screened for colorectal cancer (includes FIT kit distribution, navigation and payment for meeting screening targets) | 23 | 33 | 44 | 42 |
Cost per person screened for breast and cervical cancer (includes patient identification, navigation and payment for meeting screening targets) | 1173 | 452 | 603 | 508 |
Cost per person screened for administrative, evaluation, quality improvement and strategic planning | 112 | – | 19 | 38 |
Total promotion costs per person screened for breast, cervical and colorectal cancer | 389 | 85 | 195 | 234 |