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Reach, Usage, and Effectiveness of a Medicaid Patient Navigator Intervention to Increase Colorectal Cancer Screening, Cape Fear, North Carolina, 2011

The figure consists of a flow chart describing the selection process for eligible patients. Our initial sample of intervention patients who were eligible for the study based on Medicaid data included 242 people at 6 practices aged 50 to 75 years who were receiving Medicaid, but not Medicare, and not current with colorectal cancer screening based on Medicaid claims. After speaking to physicians and contacting patients, we found that 31 of those patients were not eligible; 2 were not eligible because the physician deemed them unfit for screening and 29 self-reported as up-to-date with screening or were unable to communicate with the patient navigator. An additional 27 people opted out of the study; 6 mailed in an opt-out card and 21 refused participation when they were called by the patient navigator. This left 184 people who were eligible at the end of the study to undergo chart review. Of these, charts were available for 166 patients. Based on chart reviews we found 21 people who had evidence of being up-to-date with screening at baseline and thus were retroactively considered ineligible. After removing these patients, we had a final sample of 163 people who were eligible to receive the intervention.

Figure. Selection of eligible patients from intervention practices to study the reach, usage, and effectiveness of a Medicaid patient navigator intervention to increase colorectal cancer screening, Cape Fear, North Carolina, 2011. Medicaid claims data used for comparison with controls was missing for 2 participants; for that analysis n = 240.

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