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HealthPartners: Closing the Gap in Health Care Disparities (Colorectal Cancer)

Colorectal cancer deaths are 48 percent higher among African-Americans than among whites, according to the US Department of Health & Human Services. As a result, HealthPartners developed customized interventions aimed at reducing disparities in colorectal cancer screening rates for African-American patients.


More than ten years ago, HealthPartners began groundbreaking work to close a gap in health care and ensure that care and service is of equally high quality for all populations, regardless of a patient’s race or ethnicity, preferred language, private insurance or public program. To identify and address these disparities, HealthPartners leaders established the Cross Cultural Care and Service Task Force in 2001, and, in 2003, the health system developed a plan to collect self-reported patient demographic data to assist in creating strategies and tactics to improve care and service for our patients.

Reduction of colorectal cancer screening disparities for African-American patients

Colorectal cancer deaths are 48 percent higher among African-Americans than among whites, according to the US Department of Health & Human Services. As a result, HealthPartners developed customized interventions aimed at reducing disparities in colorectal cancer screening rates for African-American patients.

In 2009, based on new national guidelines and guidelines from the Institute for Clinical Systems Improvement (ICSI), a nonprofit collaborative, HealthPartners expanded the eligible population for colorectal cancer screening to include African-Americans and Native Americans at age 45 instead of 50, which added more than 1,000 HealthPartners patients who needed screening.

To screen additional patients and to close the gap, HealthPartners developed several customized interventions, including:

  • Using the race information provided by patients and the electronic medical record to automatically generate reminders to African-American and Native American patients and providers to have colorectal screening beginning at age 45
  • Telephone outreach to patients who were eligible for screening
  • The option of a fecal immunochemical (FIT) test, an evidence-based alternative to colonoscopy. The electronic medical record provides a shared decision making tool for our provider to offer the FIT test for patients who prefer it over colonoscopy.

These interventions are saving lives by improving screening disparities by payer (as a measure of socioeconomic differences) and by race. HealthPartners has seen a 27 percent improvement in colorectal screening rates for African American patients since implementation. Even with the population expansion, HealthPartners screening rates continue to rise rapidly, and are already above the 2010 HEDIS 50th percentile rankings.

measure

HealthPartners Creates the Infrastructure to Deliver Optimal Care

Operating on the assumption that physicians, hospitals, and other providers truly want to deliver the best care for their patients, HealthPartners is creating the infrastructure to make optimal care the easiest care to deliver. For example, two years ago, HealthPartners introduced a radiology management program that reduced the number of unnecessary high-tech images by 7,000 in the first full year of operation–and cut costs by $6.6 million over what would have been spent without the program.


Excerpted from:

Health Finance Management Association/Leadership Case Studies: Designing Incentives that Reward High-Quality Cost-Effective Care
http://hfma.org/leadership/DesigningIncentives.html

Radiology Management
Two years ago, HealthPartners introduced a radiology management program that reduced the number of unnecessary high-tech images by 7,000 in the first full year of operation–and cut costs by $6.6 million over what would have been spent without the program.

“Under the program, physicians who use a decision-support tool in their EHRs–which informs them of the appropriate test for a given medical situation–do not have to seek approval before ordering scans. Physicians who do not use EHRs can get decision support in other ways (for example, from the referring radiologist or an online decision-support database). 70 percent of HealthPartners members are now treated by physicians with EHR-based decision support.

“Even though radiologists saw the growth of their businesses slow as referring physicians opted for fewer MRIs and PET scans, they supported the initiative because it is part of a communitywide, and highly publicized, effort to reduce unnecessary diagnostic imaging in Minnesota.

“Important support also came from HealthPartners’ Medical Group physicians. ‘Our medical group knew that we and other health plans were going to be doing something to better manage radiology, and asked, “Can we build a clinical capability to address this?”‘ says Dr. Pat Courneya, associate medical director. The medical group physicians developed the decision-support content to be used in their own medical record system–and gave the tool to other physicians in the state who use the same medical record system. . . .”

Keywords: decision support, diagnostic imaging, EHR, EMR, electronic medical record, HealthPartners Medical Group, health information technology, Minnesota, MRI, medical record system, optimal care, PET scans, radiology management, value

FOR MORE INFORMATION:

Amy von Walter
Director, Corporate Communications
HealthPartners
8170 33rd Avenue South
Bloomington, MN 55425
tel. 952.883.5274
amy.e.vonwalter@healthpartners.com
www.healthpartners.com

HealthPartners: Closing the Gap in Health Care Disparities (Breast Cancer)

HealthPartners has made significant progress toward reducing the disparity in breast cancer screening rates between white women and women of color. In 2007, the screening disparity between white women and women of color was nearly 13 percent. Since then, the disparity has closed to an average under 5 percent and, at several HealthPartners clinics, the rates are nearly identical or better in patients of color.


More than ten years ago, HealthPartners began groundbreaking work to close a gap in health care and ensure that care and service is of equally high quality for all populations, regardless of a patient’s race or ethnicity, preferred language, private insurance or public program. To identify and address these disparities, HealthPartners leaders established the Cross Cultural Care and Service Task Force in 2001, and, in 2003, the health system developed a plan to collect self-reported patient demographic data to assist us in creating strategies and tactics to improve care and service for our patients.

Reduction in breast cancer screening disparities for women of color

HealthPartners has made significant progress toward reducing the disparity in breast cancer screening rates between white women and women of color. In 2007, the screening disparity between white women and women of color was nearly 13 percent. Since then, the disparity has closed to an average under 5 percent and, at several HealthPartners clinics, the rates are nearly identical or better in patients of color.

To achieve this, HealthPartners developed customized interventions addressing barriers affecting minority populations to better serve patients. For some women, the extra encouragement from the doctor or care team during a clinic visit made obtaining the screening more likely. HealthPartners responded with a same-day mammography program in which patients overdue for a mammogram are offered the service when at the clinic for some other reason. Other interventions include transportation assistance, telephone outreach and special scripting for providers.

mammo

FOR MORE INFORMATION:

Amy von Walter
Director, Corporate Communications
HealthPartners
8170 33rd Avenue South
Bloomington, MN 55425
tel. 952.883.5274
amy.e.vonwalter@healthpartners.com
www.healthpartners.com