The dynamics of payer-provider relationships can be complicated, which is why fostering collaboration with hospitals and doctors can have a direct, measurable impact on a health plan’s overall performance. That’s why BioIQ’s at-home gap closure programs are designed to not only reduce provider friction but also to assist them in achieving their practice goals.

BioIQ recently partnered with a large health plan on a physician-led colorectal cancer (CRC) gap closure program, which resulted in gaps closed for a third of the noncompliant population, a significant increase over the plan’s previous attempts.

This plan is a leading health insurance organization that serves more than 8 million people in 29 states and delivers innovative and competitively priced healthcare products and services. The plan worked with BioIQ and its physician network to implement a customized at-home CRC screening program for its commercial and Medicare Advantage population, using BioIQ’s best-in-class FIT test kits. Physician engagement is critical to this health plan, so the program was designed to enable physicians to opt in on behalf of their patients.

At the program’s outset, the health plan identified a list of members who were overdue for CRC screening. The list was segmented according to the members’ primary care physicians, and each physician was sent a list of the patients in their practice who were eligible, along with details about the program. Each physician reviewed the list and checked off the patients that he or she thought should receive an at-home test kit, based on a variety of factors including testing history. This way, physicians were aware of the program in advance and could help the health plan identify the best candidates for this easy, at-home alternative to a colonoscopy.

Throughout the program, physicians were notified of patients’ test results so they could be prepared for appropriate follow-up appointments and next steps in care. Several physicians contacted the plan to express their appreciation for implementing the program, which motivated their patients to complete the at-home test and take a more active role in their health.

The five-year relative survival rate for stage 1 CRC is 92 percent, yet research indicates that less than 40 percent of adults are not up to date with screening. Thanks to the BioIQ program, the health plan and its network physicians were able to identify patients with both precancerous signs and early-stage CRC, which may not have been detected otherwise, and intervene accordingly to improve health outcomes.

Prior to implementing a program with BioIQ, the plan’s CRC testing processwas less convenient and physicians had a difficult time motivating patients to complete and return FIT tests. Patients were required to pick up a test at a local lab, complete it at home, and return the test to the lab. When test kits were mailed directly to members at home through the BioIQ program, physicians noticed a significant increase in returned tests. “I used to have to convince my patients to make time for their annual FIT test. Now, patients who have not completed a CRC test in years are not only doing so quickly, they’re following up with me immediately to discuss next steps if their test results are positive,” said a physician in the plan’s network. This approach contributed to a high rate of test kit returns – 27 percent for Medicare members and 20 percent for commercial members.Together with BioIQ, the health plan is looking forward to launching an expanded program and continuing to make a positive impact on members’ health.

To learn how BioIQ can enable your health plan to collaborate with providers to close care gaps, call
 (888) 818-1594 or email sales@bioiq.com.

 

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