3-minute case study: Increasing colonoscopy rates

By Lia Novotny | August 1, 2017


What innovations drive success in population health? Here's a tactic from a leading healthcare system.

The problem

Esperanza Health Centers on Chicago's Southwest Side treats 72,000 patients each year, 63 percent of whom are on Medicaid and 21 percent uninsured. To improve preventive care for its patients — primarily recent immigrants from Mexico — Esperanza focuses on key quality metrics, including rates of colorectal cancer screening.

Nationwide, the test is performed at half the rate for Spanish-speaking Hispanic patients than for white patients: 30.6 percent compared to 62 percent. Rates at Esperanza were no different, with just 30 to 35 percent of patients due for the screening receiving it.

The solution

Looking for a less invasive, more cost-effective way to increase rates of screening, two years ago Esperanza turned to the Fecal Immunochemical Test, or FIT kit. A fast and accurate test requiring no preparation, it allows patients to take a stool sample in the privacy of their homes and have it tested for early markers of colon cancer. Esperanza provides the FIT kit to patients, explains how to use it, and tests the sample at its in-house lab as soon as the patient brings it back to the clinic. Test results are available within a week.

If the result is negative, the patient simply repeats the test in another year. If it's positive, the care team does whatever is necessary to coax the patient in for a colonoscopy, including offsetting some or all of the cost.

The outcome

Since launching its culturally competent screening program, Esperanza has increased colorectal screening rates to more than 70 percent of patients requiring the test, while lowering the cost of care. While the average colonoscopy costs from $1,500 to $3,000, a FIT kit costs around $25.

The savings enable Esperanza to subsidize colonoscopies for patients with positive results from their FIT tests. According to Wayne Sottile, Esperanza's chief financial officer, FIT kits offer “a very effective and inexpensive way to improve an important metric for our patient population — and that's what's important for us."

Lia Novotny is a contributing writer for athenaInsight. Artwork by Molly Ferguson​.