Lab partnership reduces gaps in care and improves quality performance

A little more than 20 years ago, care delivery in California started to change. Large-scale independent physician associations (IPAs)—such as the subject of this case study—began taking on full-risk commercial contracts. These contracts, similar to more recent Medicare and ACO programs, were meant to improve patient care and reduce overall costs in a densely populated state. Since 2005, one large, California-based IPA has partnered with Labcorp to conduct yearly fecal occult blood test (FOBT) gap closure programs with a proven return track record of 30-40%. The success of this program is a result of the IPA care coordination team leveraging Labcorp’s data to identify patients with screening gaps and coordinate distribution of FIT testing home kits for patient collection. This made it easier for patients to fulfill screening, particularly in underserved populations.

Enhancing the gaps in care program experience with patient-centered design

Multiple agencies and organizations measure patient experience as a part of annual reporting and incentive opportunities (i.e., STARS, HCAHPS, NCQA, HEDIS®). When planning gaps in care programs, health plans and clinicians alike may use patient experience as a tool toward more effective interaction, communication and strategy in order to positively impact patients and ultimately, population health outcomes.

Engaging patients to close care gaps

As payers and providers focus on improving patient quality and population health as well as reducing costs, patient engagement is a critical piece of the puzzle and one of the most important facets of Triple Aim. But it’s not easy. Millions of patients miss out on essential tests and preventive screenings for a wide variety of reasons.

Three key steps for effectively addressing gaps in care

Getting recommended preventive screenings and regular checkups with a primary care doctor is one of the best ways for patients to maintain their health and reduce the risk of chronic diseases. Finding signs of a potential problem early—for example, via cancer screening—often means the patient has more treatment options, helping to improve quality of life and potentially save lives.