Driving quality improvement in breast cancer screening: Yuvo Health's approach with FQHCs

At Yuvo Health, we're proud to drive consistent quality improvement among our FQHC partners. Not only have we achieved shared savings in the first year of our value-based contracting program, but we have also demonstrated an overall 65% improvement in quality performance across all measures for which we have full-year data for 2022 and 2023. This includes Breast Cancer Screening, Adolescent Well Care visits, Immunizations for Adults, and Postpartum Care.

Our efforts are particularly crucial given the national landscape. An April 2024 study published in The Journal of the American Medical Association revealed that breast cancer screening rates in FQHCs (45.4%) lag significantly behind the general population (78.2%).

The discrepancy is not surprising considering the unique challenges FQHCs face, including understaffing, serving the nation’s most high-risk populations and a lack of resources that prevents them from extending their care to everyone in need.     

At Yuvo Health, we’re removing those barriers and we’re seeing results. For example, in just their first year with Yuvo, Joseph P. Addabbo Family Health Center (Addabbo), improved their Breast Cancer Screening score from 57% to 61% of eligible patients. Now, we’re creating more opportunities for screenings and tighter reporting with payers to ensure this number continues to rise and, most importantly, patient health continues to improve. 

Comprehensive support to drive success

We start by ensuring FQHCs have a path to success in their value-based contracts. We negotiate fair and equitable contracts with payers that acknowledge the unique challenges FQHCs face and the high-risk populations they serve. Gap-to-goal clauses give FQHCs a real opportunity to succeed in measures like Breast Cancer Screening. 

Then, we show our FQHC partners that they have a path to success. Better yet, there are many opportunities for improvement and Yuvo can shoulder much of the burden with end-to-end support. 

Getting more patients screened

We are helping the Addabbo team in various ways to ensure more patients get their breast cancer screening. First, using our comprehensive data analytics capabilities, we identified a list of patients who were overdue for a screening or visit. Like most FQHCs, however, the Addabbo team is stretched thin, doing as much as they can with limited staff, and does not have the resources to reach out to each of these patients individually. So we’re doing it. 

Teresa Valerio, Yuvo’s Clinical Quality Outreach Manager, personally calls patients to let them know they are due for a screening or a visit then helps them schedule their appointment in the office or with Addabbo’s mobile mammogram bus. 

One of these calls particularly stands out to Teresa. She spoke with a woman who admitted she had not been thinking about her own health as she had been caring for her critically ill husband. The woman expressed to Teresa how good it felt to have someone check in on her.

“She was so grateful,” Teresa says. “When you have calls like that, it makes your job so worth it.”

The high-touch approach is nothing new for Teresa. She has extensive experience in patient engagement, most recently serving as a Population Health Program Manager overseeing a team of six patient care coordinators skilled in addressing diverse cultural and demographic needs. She was drawn to the work because she loves connecting with patients and feeling like she’s making a real difference in their health and lives.

Improving awareness and access to screenings

We’re also working with Addabbo to increase awareness and access to screenings.  

Trenair Royal, Performance Manager at Yuvo Health, collaborates directly with the Addabbo team and is enhancing payer support and engagement for the multiple awareness and screening events the health center is hosting throughout October. Trenair has helped engage payers to sponsor events, develop educational materials specific to quality metrics, and attend events to help with patient enrollment. Fostering these connections leads to improved patient engagement, stronger relationships with payers, and ultimately, better quality outcomes for Addabbo. 

Ensuring FQHCs get credit for the work they’re doing

We have learned through our experience with value-based contracting that there are often additional opportunities for performance improvement on the back end, too. 

Many FQHCs are doing more work than they get credit for. For example, Addabbo was screening more eligible patients than were being accurately counted in their reporting. Now, our team of population health and quality improvement experts perform chart reviews and submit supplemental files that satisfy requirements on behalf of the FQHC—increasing their score without increasing their workload. 

All of these efforts support more than Breast Cancer Screening, too. 

“Since the beginning of our partnership with Yuvo, we have been fortunate enough to see improvements in almost all our quality metrics,” says Miriam Y. Vega, PhD, CEO at Joseph P. Addabbo Family Health Center.

Chart reviews and patient outreach are driving engagement and leading to more patients receiving their immunizations, more comprehensive postpartum care, and more well visits. Plus, our guidance and coding education for providers and staff are helping ensure our FQHC partners’ efforts and achievements are properly acknowledged in their performance scores across the board.

We’re leveling the playing field and showing how with the right support, like staff augmentation, expert guidance, and more favorable payer relationships, FQHCs can and will succeed.

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