Falls Community Health Partners with Local Clinic to Provide Colonoscopies at Reduced Cost
Falls Community Health (FCH) is a Federally Qualified Health Center that has joined the march to a nationwide colorectal cancer (CRC) screening rate of 80%. FCH serves all patients, but many of its patients are either underinsured or uninsured. There are close to 1,880 patients between the ages of 50 – 75, the recommended screening age for colorectal cancer. Approximately 50% of these patients are uninsured. A small percentage of FCH patients have purchased insurance through the Affordable Care Act Marketplace; however, most patients’ incomes fall within the coverage gap. Many of the patients who would be interested in insurance fall below 130% of federal poverty guidelines. The cost of healthcare in general is a concern for many of the FCH patients, especially preventive services such as cancer screening. Patients may understand that screening for colorectal cancer is the right thing to do, but they are concerned about cost. If a diagnostic colonoscopy is indicated due to a positive at-home stool test, many of the patients refuse or don’t go to their scheduled appointment because they don’t know how they will pay for the procedure.
Through a grant application with the South Dakota Community Foundation, FCH was able to partner with a local clinic that offered reduced cost colonoscopies. This partnership provided 14 colonoscopies to patients who had a positive at-home stool test and were in need of a colonoscopy. Without the grant funds, these patients would not have been able to complete the procedure due to financial barriers.
The success of the completed colonoscopies is due in large part to the navigation services provided at FCH. The CRC Navigator provided the needed education and continued communication through-out the process to ensure completion of the colonoscopy for each patient. Patients met one-on-one with the CRC Navigator prior to the colonoscopy to receive education, colonoscopy prep, and discuss any barriers that would prevent the patient from completing the procedure. The CRC Navigator followed up with each patient via phone during the time they were completing the prep for the colonoscopy and post procedure to confirm colonoscopy completion. During this call, many patients verbalized their relief on completion of the colonoscopy, gratitude for the financial assistance, and the Navigator’s assistance throughout the process.
Falls Community Health staff received the 2018 Organization of the Year award for their efforts to prioritize and advance colorectal cancer screening rates among their patients. The award was presented by the South Dakota Cancer Coalition in recognition of Colorectal Cancer Awareness Month.
“The colonoscopy wasn’t as bad as I thought it was going to be, and I’m so grateful for the help.” – Patient
“Seeing the results from the colonoscopies demonstrates the need for this program, and I’m so thankful for the funding we have received to provide these services.” – Sarah Romeo, BSN, RN
The initial project was from April through December 2017, but Falls Community Health then received additional grant funding from the Sioux Falls Community Foundation. This grant provided the financial support necessary to continue the project through 2018 – and hopefully long into the future. A recent strategy the team implemented to raise awareness about the importance of screenings is sending birthday cards to patients turning 50, with “Happy Birthday” written in many of the languages spoken by clinic patients. A first-ever 5K run/ walk called The Blue Move took place on August 11, 2018, with race registration fees being directed to help fund colonoscopies for underserved patients at Falls Community Health.
For other communities interested in a similar project, the FCH team recommends building strong relationships with the partnering clinic. This includes having a contact person who understands the process as well as the barriers that patients face. One-on-one communication with the patients and gaining their trust are keys to success.
Sara Romeo, BSN, RN
Falls Community Health