导航和临床医生支付投资提高结直肠癌筛查效益。

IF 2.1 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Portia J Zaire, A Mark Fendrick, Jacob E Kurlander, Archana Radhakrishnan
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引用次数: 0

摘要

结直肠癌(CRC)是美国癌症相关死亡的第二大原因,近40%的符合条件的个体目前没有进行挽救生命的CRC筛查。虽然基于粪便的筛查试验提供了可获得的初步选择,但如果在阳性结果后不进行后续结肠镜检查,CRC筛查过程是不完整的。不幸的是,低随访率——特别是在社会经济弱势群体中——破坏了潜在的健康益处。最近取消后续结肠镜检查患者费用分担的政策解决了一个关键障碍,但未能克服阻碍筛查完成的系统性障碍。病人导航程序是一种经过验证的弥补这些差距的策略。通过解决后勤、财政和教育方面的挑战,导航服务显著提高了结肠镜随访率。然而,偿还不足阻碍了它们的广泛实施。目前的资助模式,包括CMS的主要疾病导航服务,不足以支持CRC筛查等预防性保健。为了充分发挥结直肠癌筛查的潜力,必须对患者导航进行投资,加强临床医生对后续结肠镜检查的报销,并进行系统改革。建模研究揭示了一种“三赢”的情况:临床医生因其在后续护理中的关键作用而获得适当的补偿,支付方通过有效的筛查过程节省成本,而导航服务的投资有助于缩小结直肠癌筛查的差距。扩大导航项目和鼓励后续结肠镜检查将提高筛查率,减少差异,并实现人口健康收益。这些投资是协调利益攸关方利益、预防结直肠癌死亡和促进卫生公平的难得机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Navigation and clinician payment investments enhance colorectal cancer screening benefits.

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the US, with nearly 40% of eligible individuals not current on lifesaving CRC screening. Although stool-based screening tests offer accessible initial options, the CRC screening process is incomplete without a follow-up colonoscopy after a positive result. Unfortunately, low follow-up rates-particularly among socioeconomically disadvantaged groups-undermine the potential health benefits. Recent policies eliminating patient cost sharing for follow-up colonoscopies address one critical barrier but fail to overcome the systemic obstacles that impede screening completion. Patient navigation programs are a proven strategy to bridge these gaps. By addressing logistical, financial, and educational challenges, navigation services significantly improve follow-up colonoscopy rates. However, inadequate reimbursement has hindered their widespread implementation. Current funding models, including CMS' Principal Illness Navigation services, fall short of supporting preventive care such as CRC screening. To fully realize the potential of CRC screening, investments in patient navigation, enhanced clinician reimbursement for follow-up colonoscopies, and systemic reforms are essential. Modeling studies reveal a "win-win-win" scenario: Clinicians receive appropriate compensation for their critical role in follow-up care, payers achieve cost savings through efficient screening processes, and investments in navigation services help close disparities in CRC screening. Expanding navigation programs and incentivizing follow-up colonoscopies would increase screening rates, reduce disparities, and achieve population health gains. These investments represent a rare opportunity to align stakeholder interests, prevent CRC deaths, and advance health equity.

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来源期刊
American Journal of Managed Care
American Journal of Managed Care 医学-卫生保健
CiteScore
3.60
自引率
0.00%
发文量
177
审稿时长
4-8 weeks
期刊介绍: The American Journal of Managed Care is an independent, peer-reviewed publication dedicated to disseminating clinical information to managed care physicians, clinical decision makers, and other healthcare professionals. Its aim is to stimulate scientific communication in the ever-evolving field of managed care. The American Journal of Managed Care addresses a broad range of issues relevant to clinical decision making in a cost-constrained environment and examines the impact of clinical, management, and policy interventions and programs on healthcare and economic outcomes.
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