Priority Area: Cancer & Chronic Conditions

Goal:
100,000
fewer people with chronic conditions by 2030
Save lives by accelerating access to lung, colorectal and breast cancer screenings; Expand detection and treatment of chronic conditions by coordinating payors, providers, and foundations.
‍
LA Rate
54%
US Rate
46%
Multiple Chronic Conditions - Ages 65-74 Percentage of Medicare beneficiaries ages 65-74 with three or more chronic conditions.

‍Source: U.S. HHS, Centers for Medicare & Medicaid Services, Office of Minority Health, MappingMedicare Disparities Tool 2020; AHR‍‍

Success Measures

Percentage of adults with multiple chronic conditions

2020 Baseline
12.3%
2021 Actual
12.3%
2022 Actual
12.9%
2030 Target
9.5%
Beating Cancer

What we should know and do to drive change:

Breast Cancer
Colorectal Cancer
Lung Cancer
Hypertension
Diabetes
Issue specific to Breast Cancer
Louisiana has the fourth highest breast cancer death rate in the country. (LCP)
LA Incidence Rate
128.4
US Incidence Rate
128.1
LA Mortality Rate
22.4
US Mortality Rate
19.6
Source: NIH
Who is affected most?
  • Black women are diagnosed more frequently and more likely to die from breast cancer than the national average
  • Those who are overweight and use alcohol
Source
Solutions
  • Improve breast cancer screening rate and early detection of cancer. Screening and early detection can lead to reduced cancer-related deaths and improved outcomes for individuals diagnosed with cancer (LCP)
  • If breast cancer is caught early, the survival rate is close to 100%. It is even 72% at stage 3 with regular screenings. This shows the effectiveness of no-cost mammograms (LCP)
Breast cancer rate in my community
Current diagnosis and survival rates
LA screening rate:  74%
US screening rate: 67%
LA rate of diagnosis: New cases 2023: 4,050
US rate of diagnosis: New cases 2023:  297,790
LA survival rate: 100% caught early, 72% caught at stage 3
US survival rate: 90%
Sources: American Cancer Society; LCP; BRCF
Click the map below to access the heat map of breast cancer rates across the state.
How do I find out more?
Issue specific to Colorectal Cancer
Louisiana has the fifth highest colorectal cancer death rate in the country (LCP)
LA Incidence Rate
45.1%
US Incidence Rate
37.7%
LA Mortality Rate
15.6%
US Mortality Rate
13.1%
Source: NIH
Who is affected most?
  • Risk Factors for colorectal cancer include tobacco use, eating processed foods and red meat, obesity, and lack of screening
  • African Americans and Cajuns are more susceptible to the disease
Source
Solutions
  • Increase early screening for colorectal cancer
  • When caught early, colorectal cancer has a 90% survival rate, showing the success rate of screening (LCP)
Colorectal cancer rate in my community
Current diagnosis and survival rates
LA screening rate:  60%
US screening rate: 59%
LA rate of diagnosis: new cases 2023: 2,560
US rate of diagnosis: new cases 2023: 153,020
LA survival rate: 65%
US survival rate:  65%
Source: American Cancer Society
Click the map below to access the heat map of colorectal cancer rates across the state.
Current state of the policy
Louisiana’s screening rates are outpacing the national average (LCPScreen Up)
How do I find out more?
  • Screenup is working towards increasing cancer screening rates at Federally Qualified Health Centers (FQHCs) throughout the state (LCP Screen Up)
  • Louisiana Colorectal Cancer Roundtable works to increase screening rates and with partners, issues a legislative report each year that outlines the problem, data, progress, barriers and recommendations (LCP Report)
  • Colorectal screenings and their pros and cons (American Cancer Society’s explanation)
  • Symptoms of colorectal cancer (LCP)
Issue specific to Lung Cancer
1 out of 3 people who die in Louisiana die from lung cancer. Lung cancer is the top cancer killer in Louisiana. (LCP)
LA Incidence Rate
63.4%
US Incidence Rate
56.3%
LA Mortality Rate
43.5%
US Mortality Rate
35%
Source: NIH
Who is affected most?
  • More than 80% of lung cancers are caused by smoking and secondhand smoke. See page on Smoking Cessation
  • Tobacco companies target populations more at risk for smoking such as young people and minorities
Source
Solutions
Source
Lung cancer rate in my community
Current diagnosis and survival rates
‍LA rate of diagnosis: new cases 2023: 3,850
US rate of diagnosis: new cases 2023: 238,340
LA survival rate: 23%
US survival rate: 22%
Source: American Cancer Society
Click the map below to access the heat map of lung cancer rates across the state.
How do I find out more?
  • Louisiana Cancer Prevention raises awareness and educates the public, providers, and legislatures with materials about the dangers associated with tobacco and e-cigarettes. They link users with providers to help them quit.
  • Quit with Us, LA helps smoker quit with counseling plan, quit plan, and other resources. They also have specific information on Louisiana smokers and how it affects those around them.
  • Louisiana Tobacco Control Initiative offers free or low-cost evidence-based tobacco treatment to Louisianians.
  • Get Help/Quit Smoking, Smoking Cessation Trust, offers no-cost cessation services such as medication, individual/group counseling, telephone quit-line support and/or intensive cessation support services.
  • Check out this infographic if you think you are at risk and want to be screened:
Issue specific to Hypertension
Heart diseases and stroke are the leading and fifth-leading causes of death in theUnited States, respectively. High blood pressure (or hypertension) is a major risk factor for heart disease and stroke. Based on America’s Health Ranking’s data, in 2019, more than 102,000 deaths were primarily attributable to high blood pressure (AHR) 
LA Rate
40.2%
US Rate
32.4%
Source: AHR
In Louisiana….
‍Percentage of adults who reported being told by a health professional that they had high blood pressure.
Who is affected most?
  • Adults over 65
  • Men compared to women
  • Black and American Indian/Alaskan Native adults compared with Asian Adults
  • Adults with lower socioeconomic status compared with those with higher socioeconomic status
  • Adults with less than a high school degree
  • Adults with an annual household income less than $25,000
  • Adults living in non-metropolitan areas compared with those in metropolitan areas
  • Risk factors include smoking, overweight and obesity, physical inactivity, high blood pressure and high cholesterol
Source
Solutions
Improve control of hypertension among adults in Louisiana through improving access to high quality care and reducing risk factors:
Increase access to high quality care:
  • CDC information on prevention and management of hypertension (CDC)
  • Ochsner hypertension and diabetes digital medicine programs (Ochsner Health)
  • The Adult Congenital Heart Disease (ACHD) study is led by the Louisiana Public Health Institute in partnership with Children’s National Hospital and seeks to establish a congenital heart disease (CHD) surveillance program through PCORnet to understand the impact of gaps in recommended care in CHD patients and create a cohort of patients of various CHD disease subtypes for prospective studies. Participating REACHnet sites include Ochsner Health and University of California at San Francisco. Patient-centered Outcomes Research Institute
FACTS:
  • Value-based payment models are more effective in achieving better health outcomes by incentivizing providers to achieve certain quality metrics. Expand partnership to more payors and providers to participate in value-based payment programs to improve rates of hypertension and diabetes control among adults within Louisiana
  • Access to primary care improves health outcomes by providing preventative care, early detection, and timely treatment
  • Remote monitoring programs improve hypertension and diabetes control through early detection of complications, better patient engagement, and reduced healthcare cost
Current state of the policy
  • Currently 94% of Louisiana residents live in a Primary Care Health Professional Shortage Area (Well-Ahead)
  • Currently digital medicine programs are not covered by all health plans/payors
  • Examining the largest and long-running value-based payment initiatives in the US showed improvement in both quality and health outcomes. There was an average of 7% increase in percentage of enrollees who met criteria for quality care with respect to diabetes care among patients in VBP while there was no change in the comparison group. The same study showed outcome measures for hypertension control and diabetes control among enrollees with diabetes improved from 75% in 2009 to 85% in 2016 among patients in Alternative Quality Contract, while there was a slightly decline in outcome measures among the comparison groups (New England Journal of Medicine)
  • Examined whether alternative payment models and value-based insurance designs improve diabetes care and found that these models are promising first steps in redesigning the payment system to improve diabetes care. However, greater coordination and alignment across models is needed to enhance their impact on providers’ behavior, diabetes care processes, and patient health outcomes (Health Affairs)
  • Access to primary care is associated with prevention of illness and death (NIH)
  • Primary care serves as the cornerstone for building a strong healthcare system that ensures positive health outcomes and health equity (Hindawi)
  • Adherence to medications is associated with lower health care utilization and expenditure (NIH)
  • Louisiana currently has 34 FQHC organizations providing primary care services to more than 465,000 patients (Rural Health Information Hub)
  • There are 213 Rural Health Clinics providing primary care and preventive services in rural, underserved areas (Chronicles)
  • Today, Louisiana Medicaid serves over 1.8 million Louisianans, approximately 39% percent of the state’s population (LDH)
  • For patients failing hypertension and diabetes oral therapy, this DMO, which provides dose-by-dose feedback on medication ingestion adherence, can help lower BP, HbA1c, and LDL-C, and promote patient engagement and provider decision making (NIH)
High blood pressure rate in my community
PLACES, a collaboration between CDC, the Robert Wood Johnson Foundation, and the CDC Foundation, provides health data for small areas across the country. This allows local health departments and jurisdictions, regardless of population size and rurality, to better understand the burden and geographic distribution of health measures in their areas and assist them in planning public health interventions.

PLACES provides model-based, population-level analysis and community estimates of health measures to all counties, places (incorporated and census designated places), census tracts, and ZIP Code Tabulation Areas (ZCTAs) across the United States. Learn more about PLACES.
Click the map below to be directed to the CDC heat map and navigate to Hypertension (high blood pressure).
Issue specific to Diabetes
Diabetes and heart diseases are among the top 10 leading causes of death in the United States in 2020. Based on America’s Health Ranking’s data, diabetes accounts for 102,188 deaths annually. Those with diabetes are twice as likely to have heart disease or a stroke than those without diabetes (AHR)
LA Rate
13.6%
US Rate
10.9%
Source: AHR
In Louisiana…
‍Percentage of adults who reported ever being told by a health professional that they have diabetes (excluding prediabetes and gestational diabetes):
Who is affected most?
  • Adults over 65
  • Men compared to women
  • Black and American Indian/Alaskan Native adults compared with Asian Adults
  • Adults with lower socioeconomic status compared with those with higher socioeconomic status
  • Adults with less than a high school degree
  • Adults with an annual household income less than $25,000
  • Adults living in non-metropolitan areas compared with those in metropolitan areas
  • Risk factors include smoking, overweight and obesity, physical inactivity, high blood pressure and high cholesterol
Source
Solutions
Improve control of hypertension among adults in Louisiana through improving access to high quality care and reducing risk factors:
Increase access to high quality care:
FACTS:
  • Value-based payment models are more effective in achieving better health outcomes by incentivizing providers to achieve certain quality metrics. Expand partnership to more payors and providers to participate in value-based payment programs to improve rates of hypertension and diabetes control among adults within Louisiana
  • Access to primary care improves health outcomes by providing preventative care, early detection, and timely treatment
  • Remote monitoring programs improve hypertension and diabetes control through early detection of complications, better patient engagement, and reduced healthcare cost
MORE INFORMATION:
LOUISIANA EXPERIMENT ASSESSING DIABETES – ZERO DOLLAR COPAYMENT (LEAD-ZDC): LEAD-ZDC is a prospective observational study to assess the effectiveness of zero dollar copayment for select common diabetes medications on patients’ medication adherence, blood glucose (A1c) control, diabetes complications, and healthcare utilization. Tulane University is leading the study in collaboration with Blue Cross Blue Shield of Louisiana and REACHnet partners in Louisiana. Tulane


Current state of the policy
  • Currently 94% of Louisiana residents live in a Primary Care Health Professional Shortage Area (Well-Ahead)
  • Currently digital medicine programs are not covered by all health plans/payors
  • Examining the largest and long-running value-based payment initiatives in the US showed improvement in both quality and health outcomes. There was an average of 7% increase in percentage of enrollees who met criteria for quality care with respect to diabetes care among patients in VBP while there was no change in the comparison group. The same study showed outcome measures for hypertension control and diabetes control among enrollees with diabetes improved from 75% in 2009 to 85% in 2016 among patients in Alternative Quality Contract, while there was a slightly decline in outcome measures among the comparison groups (New England Journal of Medicine)
  • Examined whether alternative payment models and value-based insurance designs improve diabetes care and found that these models are promising first steps in redesigning the payment system to improve diabetes care. However, greater coordination and alignment across models is needed to enhance their impact on providers’ behavior, diabetes care processes, and patient health outcomes (Health Affairs)
  • Access to primary care is associated with prevention of illness and death (NIH)
  • Primary care serves as the cornerstone for building a strong healthcare system that ensures positive health outcomes and health equity (Hindawi)
  • Adherence to medications is associated with lower health care utilization and expenditure (NIH)
  • Louisiana currently has 34 FQHC organizations providing primary care services to more than 465,000 patients (Rural Health Information Hub)
  • There are 213 Rural Health Clinics providing primary care and preventive services in rural, underserved areas (Chronicles)
  • Today, Louisiana Medicaid serves over 1.8 million Louisianans, approximately 39% percent of the state’s population (LDH)
  • For patients failing hypertension and diabetes oral therapy, this DMO, which provides dose-by-dose feedback on medication ingestion adherence, can help lower BP, HbA1c, and LDL-C, and promote patient engagement and provider decision making (NIH)
High blood pressure rate in my community
PLACES, a collaboration between CDC, the Robert Wood Johnson Foundation, and the CDC Foundation, provides health data for small areas across the country. This allows local health departments and jurisdictions, regardless of population size and rurality, to better understand the burden and geographic distribution of health measures in their areas and assist them in planning public health interventions.

PLACES provides model-based, population-level analysis and community estimates of health measures to all counties, places (incorporated and census designated places), census tracts, and ZIP Code Tabulation Areas (ZCTAs) across the United States. Learn more about PLACES.
Click the map below to be directed to the CDC heat map and navigate to Diabetes.
Download our Healthy State Fact Sheet on Cancer and Chronic Conditions
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