Three screenings. One managed service.
Colorectal cancer, hemoglobin A1c, and kidney health evaluation. These are the three preventive measures with the widest gaps in Medicaid populations, the highest downstream cost when missed, and the best case for home-based screening as an operational solution.
Colorectal cancer screening.
One of the most preventable cancers, systematically underdiagnosed in populations who face the highest barriers to colonoscopy access.
Clinical rationale
Colorectal cancer kills roughly 53,000 Americans each year. Five-year survival exceeds 90% when caught at stage I. It falls below 15% when caught at stage IV. The screening test works. The barrier is access.
Colonoscopy is the gold-standard screening, but it requires transportation, bowel prep, sedation, and a day off work. FIT—the fecal immunochemical test—is a USPSTF-recognized alternative that can be completed at home, requires no prep, and costs less than $25 per kit. For Medicaid populations, FIT is often the difference between a completed screening and no screening at all.
Member experience
A text message. A conversation. A kit in the mail within days. Instructions on the inside of the box. A small sample returned in a postage-paid envelope.
Results in one to two weeks. If the test is negative, a follow-up confirming the result and a reminder to screen again next year. If the test is positive, an immediate SMS from the care team to schedule a diagnostic colonoscopy, coordinated by our nurses and tracked to completion.
Diabetes control (HbA1c).
The best early indicator of whether a member's diabetes is under control, and one of the most predictive numbers in all of preventive care.
Clinical rationale
Hemoglobin A1c measures the average blood glucose level over the preceding two to three months. An HbA1c below 8% substantially reduces the risk of diabetic retinopathy, neuropathy, nephropathy, and cardiovascular complications. An HbA1c above 9% is associated with dramatically accelerated disease progression.
Despite this, 28% of FQHC diabetic patients have uncontrolled blood sugar or received no A1c test during the measurement year. Not because the test is complicated. Because getting a member in for the draw, coordinating the lab, and closing the loop on the result is operationally expensive.
Member experience
A capillary sampling kit arrives at home. A small finger-stick produces enough blood for a lab-quality A1c result. The member completes the draw at home, seals the sample, and mails it back.
Results return within a week. Members in range receive a confirmation and a reminder for next year's test. Members out of range are contacted by the care team with a recommended next step, and the member's primary care provider is notified with a structured clinical summary.
Kidney health evaluation.
The most persistent measure gap in Medicaid, and the most responsive to home-based collection. This is where the widest distance between commercial and Medicaid performance exists.
Clinical rationale
About 40% of adults with diabetes will develop chronic kidney disease. Catching it early—before symptoms appear, before the kidneys have sustained permanent damage—is what makes intervention possible. The KED measure requires both a serum eGFR and a urine albumin-to-creatinine ratio (uACR) within the measurement year.
The uACR is where the gap lives. Most members with diabetes have had an eGFR drawn routinely, but uACR completion trails badly. Annual uACR requires a urine sample, which requires an office visit, which is the exact barrier our model removes.
Member experience
A kit containing a collection cup and a stabilizing dropper. Simple written and video instructions. A return envelope for the sample.
Results return in a week. In-range results are documented. Out-of-range results trigger escalation to the primary care team with a recommendation for nephrology referral if clinically warranted. The combined eGFR and uACR close the KED measure.
The model in your numbers.
Share your population size and measure priorities. We'll build a specific impact estimate for what the three-screening program could look like against your book of business.
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