Preventive care reminders
We’re contacting people with our insurance to remind them about vaccines and cancer screenings they’ve missed.
Why are preventive screenings and vaccines important?
Preventive care identifies problems early, before they become serious. It can help prevent disease. From cancer screenings to vaccines, everyone should get preventive care to stay healthy. But not everyone does. People with health insurance through public programs usually go to fewer preventive care appointments than people with insurance through their employer. We're working to change that.
What did we do to increase screenings and vaccines?
Today, we're contacting people with our insurance to remind them about vaccines and cancer screenings they've missed. We encourage members to see the doctor for recommended preventive care. When members fall behind, we contact them with a reminder.
Two organizations set the guidelines for preventive care in the United States: The Institute for Clinic Systems Improvement and the U.S. Preventive Services Task Force. They make recommendations for things like colorectal cancer screenings and vaccines.
We contacted people based on these guidelines:
- Breast cancer screening: women ages 50-75
- Cervical cancer screening: women ages 21-64
- Colorectal cancer screening: women ages 50-75
- African-Americans, American Indians and Alaska Natives begin screening at age 45
- Pediatric immunizations: children under age 2
- Adolescent immunizations: ages 11-12
We're measuring outreach to people with these types of insurance:
- Insurance through an employer (commercial)
- Insurance through Prepaid Medical Assistance Program (public program)
- Insurance through Minnesota Senior Health Options (public program)
How did we remind people to get care?
We started a program to send reminders. Claims data helps us identify who needs a reminder email. We won’t contact you if you’re up-to-date on preventive care.
Here are a few ways we’re reminding people:
- Case management staff see alerts for preventive services in their system, so they can remind members when they’re due for care.
- Internal and external communications, such as social media, build awareness of cancer screenings.
- People with our health insurance can choose if they want reminders in the mail or online (via secure web mail).
- Health Risk Assessments also alert members to preventive services they may need.
- We update and improve messages based on feedback from our online member panel. Our member panel tells us what they like, don’t like and what would encourage them to get care.
Incentives:
- Prepaid Medical Assistance Program (PMAP) members get an incentive for completing all adolescent immunizations by age 13.
- Minnesota Senior Health Options (MSHO) members get an incentive for completing a mammogram, colorectal cancer screening or osteoporosis screening.
Pilot testing:
We recently conducted a colorectal cancer screening pilot. We mailed stool tests called fecal immunochemical tests (FITs) to people without a primary care provider listed in our system. We also sent information about the importance of colon cancer screening. We asked members to collect a sample at home and mail it back to the lab.
How are we working on preventive care with our doctors and teams?
- We regularly update the list of members who are behind on vaccines or cancer screenings. Every quarter, providers are notified and new data is made available.
- Preventive measures are included in HealthPartners provider incentive program, Partners in Excellence. This helps incentivize more preventive care.
- Network quality improvement leaders meet regularly at the Quality Connections Forums. There, they discuss the latest science and best practices around quality improvement.
- Consultations are available for medical groups interested in improving their quality outcomes.
What challenges do we face?
Preventive guidelines change. It can be confusing for members to know when to start screening and how often to go. It can also be challenging to learn about different screening options. This was particularly true in 2017 for cervical and breast cancer screening.
Results
Here's what our work has done for vaccine and test rates since 2015. You can see the outcomes for people with HealthPartners insurance through a public program below. You can also see the rates for people with commercial insurance. Percents show the number of people with HealthPartners insurance who got the recommended shot or test.
| 2015 | 2016 | 2017 | |
|---|---|---|---|
| HEDIS measures (commercial insurance only) | |||
| Breast cancer screening | 78.7% | 81.1% | 79.4% |
| Cervical cancer screening | 78.1% | 79.5% | 77.4% |
| Colorectal cancer screening | 74.9% | 69.2% | 69.2% |
| Pediatric immunization combo 3 | 82.6% | 82.7% | 84.4% |
| Adolescent immunization combo 1 | 74.9% | 88.5% | 92.0% |
| Chlamydia screening | 52.9% | 53.9% | 53.2% |
| Postpartum visit | 84.9% | 84.7% | 83.0% |
| HEDIS measures (Prepaid Medical Assistance Program only) | |||
| Breast cancer screening | 67.5% | 73.9% | 68.4% |
| Cervical cancer screening | 73.5% | 72.0% | 66.4% |
| Pediatric immunization combo 3 | 72.5% | 76.9% | 75.4% |
| Adolescent immunization combo 1 | 78.1% | 89.5% | 87.4% |
| Chlamydia screening | 68.4% | 71.3% | 67.5% |
| Postpartum visit | 69.6% | 65.0% | 72.3% |
| HEDIS measures (Minnesota Senior Health Options only) | |||
| Breast cancer screening | 69.6% | 70.8% | 66.4% |
| Colorectal cancer screening | 62.5% | 61.9% | 66.6% |
Ongoing work
We're committed to improving the number of people who get preventive care. In 2018, we updated a communication system. This improved our ability to reach members with the right message, at the right time, in the right way.
We'll continue to use the online member survey to make sure each message resonates. And we'll expand the use of alternative options such as fecal immunochemical tests (FITs). These noninvasive tests look for the presence of hidden blood in the stool, which can be a sign of a number of gastrointestinal disorders, including cancer. We're always looking for new ways to promote screenings and immunizations.