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 |
aUp to 30% for completion rate for breast and cervical navigation and up to 20% for completion rate for colorectal cancer screening
bCost of FIT kit tests, screening tests, and diagnostic procedures are not included. Therefore, the costs presented in the table do not include clinical cost of delivering screening
FY, fiscal year