Date of Conferral

2021

Degree

Ph.D.

School

Public Health

Advisor

Jeanne Connors

Abstract

Public health initiatives include vaccination and screening efforts to reduce the burden of disease. This study addressed colorectal cancer (CRC) screening behaviors of accountable care organization (ACO) patients with different social determinants of health and providers’ ability to comply with the Medicare Shared Savings Plan (MSSP) quality measure ACO #19. This study followed the socioecological model and a cross-sectional quantitative design to assess data from the MSSP public use file 2019 across three manuscripts to expand on current literature. The purpose was to determine whether patient behavior was the primary driver to improve healthcare quality. Study results showed that performance rates increased in ACOs that had a greater number of patients. ACOs with more non-White patients and more Medicaid patients were less successful with CRC screening. Performance was highest when more patients were between 65-85 years of age as compared to patients under 65 or over 85 years old. The implications for positive social change in this study include data for policy makers, health, and public health care professionals to reduce disparities for CRC screening and incidence of CRC among vulnerable populations. The data also support population health initiatives beyond CRC-related illness.

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