Step 1: Select Model

Review the table below to select one of the following models:


Overview of Models


State Oregon North Carolina
Population 68,077 Oregon Medicaid enrollees ages 50-64, not up-to-date on CRC screening, and enrolled in a coordinated care organization 3,298,265 North Carolina residents ages 50-75 not up-to-date on CRC screening with different types of insurance (private, Medicare, Medicaid, dual Medicare/Medicaid, uninsured)
Intervention Period 5-year period (January 1, 2019 – December 31, 2023) 5-year period (January 1, 2020 – December 31, 2024)
Interventions simulated 5 interventions were selected to compare to usual care that have been shown to be effective in Medicaid and low-income populations:
  1. Patient reminders
  2. Mailed FIT
  3. Patient navigation
  4. Mailed FIT + patient navigation
  5. Academic detailing + provider assessment and feedback
 4 intervention bundles* were selected to compare to usual care that were identified as "go big" strategies potentially capable of achieving high screening targets:
  1. Mailed FIT
  2. Patient navigation to screening colonoscopy
  3. Provider assessment and feedback
  4. Mailed FIT for Medicaid enrollees
Intervention implementation costs Derived from prior studies implementing similar interventions in populations similar to the Oregon Medicaid population Estimated costs of bundled interventions based on prior literature, summed across intervention component
Medicaid expansion Oregon expanded Medicaid in 2014. Interventions are layered on top of Medicaid expansion North Carolina has not yet expanded Medicaid. Results are reported for each intervention with and without Medicaid expansion
Intervention reach+ Interventions assumed to reach 100% of the target population of Oregon Medicaid enrollees Results are available assuming different levels of intervention reach: 25%, 50%, 75%, and 100%
Outcomes assessed Percent up-to-date on CRC screening, CRC cases averted, CRC deaths averted, costs/cost-savings, cost-effectiveness per additional person up-to-date on CRC screening, cost-effectiveness per life-year gained Percent up-to-date on CRC screening, CRC cases averted, CRC deaths averted, costs/cost-savings, cost-effectiveness per additional person up-to-date on CRC screening, cost-effectiveness per life-year gained

*Bundled multicomponent interventions combine at least two components intended to increase the demand for, access to, and/or provider delivery of screening services.
+Intervention reach is defined as the percentage of the target population exposed to the intervention.

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