OB/Gyn Preventive Measures
Health Partners has partnered with a health plan in order to increase the percentage of women in the health plan who receive the recommended age-specific preventive screenings and wellness consultation from OB/Gyn physicians. The program's goals are to:
1. Prevent and diagnosis specific diseases in early stages.
2. Focus resources on wellness and weight management.
3. Focus on improving the partnering health plan's HEDIS scores.
Ob/Gyn physicians have been targeted for this project because they serve as a routine source for preventive and acute care for most females in the health plan. The program focuses on five areas:
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Project Measures |
Performance Goals* |
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1) The percentage of women 40-69 years of age who had a mammogram to screen for breast cancer in the past two years at the end of the measurement period. |
80% of female patients (2009 National HEDIS 90th percentile) |
|
2) The percentage of women 21-64 years of age who received a Pap test to screen for cervical cancer in past 36 months at the end of the measurement period. |
87% of female patients (2009 National HEDIS 90th percentile) |
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3) The percentage of female members 50-75 who had appropriate screening for colorectal cancer since 2005. Appropriate screenings are defined as follows: a. Fecal occult blood test during 2010 b. Flexible sigmoidoscopy between 2005 & 2010 c. Double contrast barium enema or air contrast barium enema between 2005 & 2010 d. Colonoscopy between 2000 & 2010 |
68% of female patients (2009 National HEDIS 90th percentile) |
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4) The percentage of women 50 years of age or older who have been diagnosed with osteoporosis who were prescribed treatment at the end of the measurement period. |
72% of female patients (Associate Health Plan 2009 Baseline plus 5%) |
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5) The percentage of females 18-74 who had their body mass index (BMI) in the measurement year or year prior documented through either administrative data or medical record. |
80% of female patients (No benchmark available) |
These five areas of focus have a strong correlation for preventing long-term disease development, premature death, and in the case of obesity, the prevention of other chronic disease associated with obesity.
Partnering OB/Gyn physicians are provided physician specific reports on the number of health plan patients who have utilized their services, individual compliance rates for the five measures, and educational resources to assist their patients in obtaining the necessary screening and weight loss / obesity management.
Impact:
Economic Impact
The estimated overall cost of cancer in 2008 was $228.1 billion, which includes breast, cervical and colorectal cancers. In addition, it is estimated that obesity accounts for 5-7% of the total healthcare costs per year or an estimated $100 billion per year.
Medical Impact
Breast cancer: There were over 192,000 new cases of female breast cancer and over 40,000 female deaths due to breast cancer in the US in 2009. Routine mammography can diagnosis breast cancer in early stages resulting in less invasive treatment plans and higher clinical treatment success rates.
Cervical cancer: There were over 50,000 new cases of associated cervical cancer and over 11,000 deaths in the US in 2009. Routine cervical cancer screening can diagnosis cervical cancer in early stages resulting in less invasive treatment plans and higher clinical treatment success rates.
Colorectal cancer: There were over 74,000 new cases of female colorectal cancers and over 25,000 female deaths in the US in 2009. Routine colorectal cancer screening in women can diagnosis colorectal cancer in earlier stages resulting in less invasive treatment plans and higher clinical treatment success rates.
Osteoporosis Management: Women who have been diagnosed with osteoporosis have an increased risk of bone fractures and musculoskeletal injury. The proper management of osteoporosis minimizes these risks.
Obesity: A high body mass index and obesity are correlated with higher rates of cardiovascular disease, cancer and other chronic health conditions.