Member Adherence to a Health Insurer-Sponsored Gap Closure Program Using Multi-Target Stool DNA Test for Colorectal Cancer Screening

Objectives: To describe member adherence to a mail-based, health insurer-sponsored gap closure program for colorectal cancer (CRC) screening using multi-target stool DNA (mt-sDNA; Cologuard ® ) tests. Methods: Combined patient data from Exact Sciences Laboratories LLC and data from mass-mailed mt-sD...

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Main Authors: Mallik Greene, Timo Pew, Quang Le, Alisdair Philp, William K. Johnson, A. Burak Ozbay, John Kisiel, Michael Dore, Derek Ebner, A. Mark Fendrick, Paul Limburg
Format: Article
Language:English
Published: SAGE Publishing 2024-12-01
Series:Journal of Primary Care & Community Health
Online Access:https://doi.org/10.1177/21501319241305958
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author Mallik Greene
Timo Pew
Quang Le
Alisdair Philp
William K. Johnson
A. Burak Ozbay
John Kisiel
Michael Dore
Derek Ebner
A. Mark Fendrick
Paul Limburg
author_facet Mallik Greene
Timo Pew
Quang Le
Alisdair Philp
William K. Johnson
A. Burak Ozbay
John Kisiel
Michael Dore
Derek Ebner
A. Mark Fendrick
Paul Limburg
author_sort Mallik Greene
collection DOAJ
description Objectives: To describe member adherence to a mail-based, health insurer-sponsored gap closure program for colorectal cancer (CRC) screening using multi-target stool DNA (mt-sDNA; Cologuard ® ) tests. Methods: Combined patient data from Exact Sciences Laboratories LLC and data from mass-mailed mt-sDNA orders placed by a large Medicare Advantage Insurance Plan were analyzed (03/01/2023-06/30/2023). Adherence and time to test return were the primary and secondary outcomes, respectively. Their association with patient characteristics was evaluated using multivariable regression. Results: Among the 3201 member-patients included (86.6% aged 65-75 years; 58.7% female), adherence rate was 49.4%, and mean time to test return was 25.5 days. After multivariable adjustment, the odds of test return were significantly higher among 65- to 75-year-olds (odds ratio [OR] = 1.59 relative to 45- to 64-year-olds), those living in small towns (OR = 1.43 relative to metropolitan-located individuals), and with digital outreach via both SMS and email (OR = 4.31 relative to no digital outreach). Time to test return was shorter in 65- to 75-year-olds than in 45- to 64-year-olds and was not associated with other patient characteristics. Conclusions: Mass-mailed mt-sDNA tests for CRC screening were associated with an overall adherence rate of about 50% in this Medicare Advantage population, with higher likelihood of test return among patients receiving digital outreach.
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spelling doaj-art-0ee1a9ee0a0745ae967079dd46c7c8d42025-08-20T01:59:16ZengSAGE PublishingJournal of Primary Care & Community Health2150-13272024-12-011510.1177/21501319241305958Member Adherence to a Health Insurer-Sponsored Gap Closure Program Using Multi-Target Stool DNA Test for Colorectal Cancer ScreeningMallik Greene0Timo Pew1Quang Le2Alisdair Philp3William K. Johnson4A. Burak Ozbay5John Kisiel6Michael Dore7Derek Ebner8A. Mark Fendrick9Paul Limburg10Exact Sciences Corporation, Madison, WI, USAExact Sciences Corporation, Madison, WI, USAExact Sciences Corporation, Madison, WI, USAExact Sciences Corporation, Madison, WI, USAExact Sciences Corporation, Madison, WI, USAExact Sciences Corporation, Madison, WI, USAMayo Clinic, Rochester, MN, USADuke University, Durham, NC, USAMayo Clinic, Rochester, MN, USAUniversity of Michigan, Ann Arbor, MI, USAExact Sciences Corporation, Madison, WI, USAObjectives: To describe member adherence to a mail-based, health insurer-sponsored gap closure program for colorectal cancer (CRC) screening using multi-target stool DNA (mt-sDNA; Cologuard ® ) tests. Methods: Combined patient data from Exact Sciences Laboratories LLC and data from mass-mailed mt-sDNA orders placed by a large Medicare Advantage Insurance Plan were analyzed (03/01/2023-06/30/2023). Adherence and time to test return were the primary and secondary outcomes, respectively. Their association with patient characteristics was evaluated using multivariable regression. Results: Among the 3201 member-patients included (86.6% aged 65-75 years; 58.7% female), adherence rate was 49.4%, and mean time to test return was 25.5 days. After multivariable adjustment, the odds of test return were significantly higher among 65- to 75-year-olds (odds ratio [OR] = 1.59 relative to 45- to 64-year-olds), those living in small towns (OR = 1.43 relative to metropolitan-located individuals), and with digital outreach via both SMS and email (OR = 4.31 relative to no digital outreach). Time to test return was shorter in 65- to 75-year-olds than in 45- to 64-year-olds and was not associated with other patient characteristics. Conclusions: Mass-mailed mt-sDNA tests for CRC screening were associated with an overall adherence rate of about 50% in this Medicare Advantage population, with higher likelihood of test return among patients receiving digital outreach.https://doi.org/10.1177/21501319241305958
spellingShingle Mallik Greene
Timo Pew
Quang Le
Alisdair Philp
William K. Johnson
A. Burak Ozbay
John Kisiel
Michael Dore
Derek Ebner
A. Mark Fendrick
Paul Limburg
Member Adherence to a Health Insurer-Sponsored Gap Closure Program Using Multi-Target Stool DNA Test for Colorectal Cancer Screening
Journal of Primary Care & Community Health
title Member Adherence to a Health Insurer-Sponsored Gap Closure Program Using Multi-Target Stool DNA Test for Colorectal Cancer Screening
title_full Member Adherence to a Health Insurer-Sponsored Gap Closure Program Using Multi-Target Stool DNA Test for Colorectal Cancer Screening
title_fullStr Member Adherence to a Health Insurer-Sponsored Gap Closure Program Using Multi-Target Stool DNA Test for Colorectal Cancer Screening
title_full_unstemmed Member Adherence to a Health Insurer-Sponsored Gap Closure Program Using Multi-Target Stool DNA Test for Colorectal Cancer Screening
title_short Member Adherence to a Health Insurer-Sponsored Gap Closure Program Using Multi-Target Stool DNA Test for Colorectal Cancer Screening
title_sort member adherence to a health insurer sponsored gap closure program using multi target stool dna test for colorectal cancer screening
url https://doi.org/10.1177/21501319241305958
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