NCQA Seeks Health Plans for Study on Barriers to Follow-Up Colonoscopy

May 30, 2022 · Matt Brock

Colorectal cancer screenings are free for people with commercial insurance and for Medicaid and Medicare Advantage beneficiaries.

doctor colonoscopy

But there’s a catch. When people who choose a non-colonoscopy initial screening get a positive result, the needed follow-up colonoscopy is subject to cost sharing.

It’s a situation that may create barriers, dragging down already-low rates of colorectal cancer screenings by:

  • Creating a cost barrier when a follow-up colonoscopy is needed
  • Preventing some from completing any form of screening
  • Discouraging some from selecting the best option to meet their individual needs

The Opportunity for Health Plan Participants

To study this, NCQA is inviting health plans to join a one-year quality improvement learning collaborative. It will focus on improving adherence to follow-up colonoscopy. Health plans that participate will:

  • Learn best practices to improve follow-up after a positive non-invasive colorectal cancer screening. This includes quality improvement engagement with diverse patient and beneficiary groups.
  • Receive training and resources to support quality improvement efforts.
  • Get technical assistance on benchmarking and monitoring progress.
  • Receive an honoraria for meeting participation requirements, including a stipend for patient participant honoraria.

 How to Participate

To participate in the learning collaborative, which kicks off in July and wraps up in September 2023, health plans should have:

  • Access to clinical/claims data to track baseline and interim utilization rates.
  • Ability to connect with provider groups and networks for participation in quality improvement activities.

In addition, participants should be prepared to attend regular meetings and dedicate resources to engage with patients.

For more information, contact the Learning Collaborative Team at

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