Since the 1990s, patient navigators have helped guide and support patients through a diagnosis, or suspected diagnosis, to address any barriers patients may encounter within the health care system. This ensures patients are informed and receiving timely treatment. Patient navigation programs have traditionally been attributed to oncology; however, these programs have demonstrated value across different lines of care, especially in geriatric care where care is costly and multifaceted. 1
Patients can benefit immensely from navigator programs. Navigators ultimately ensure that patient needs and questions are addressed, that they are adhering to their medication plans, and that they are well-informed of their diagnosis and treatment status. By working one-on-one with patients, navigators help address broader health disparities, such as language barriers, that may not be feasible to clinicians due to resource and/or time constraints. This helps support patients during critical, and often complex, times in their health by providing them with the necessary tools and guidance needed in treatment and healing. 2
Patient navigator programs benefit not only patients, but also help improve cost outcomes. A study by Rocque, Gabrielle B., Pisu, M. et al. examines cost and resource use related to cancer among older adults (Medicare beneficiaries 65 years or older) receiving care at The University of Alabama at Birmingham (UAB) Health System Cancer Community Network (CCN). In the study, the Patient Care Connect Program (PCCP) was implemented, which aimed to optimize costs through the integration of lay navigators within the CCN. Using claims data, navigated patients and non-navigated patients were observed from 2012-2015 for any changes in total Medicare costs and resource use. Costs related to hospitals, outpatient, and physician visits were examined. Those in the navigated group, comprised of a single navigator and 152 patients, had declining costs for a total of over $475,000 reduction, annually. The reduction takes into account an average salary and benefit investment estimated at $48,448 for the navigator. ED visits and hospitalizations of those in the navigated groups decreased by 6% and 10.6%, respectively, per quarter compared to those in the comparison group (non-navigated). The study helps quantify the value of patient navigators in a health care setting, including through the prevention of ED and hospitalizations that may also improve patient experience. This study can be found here: http://jamanetwork.com/journals/jamaoncology/fullarticle/2598743 1
Incorporating a patient navigation program into a health system can be beneficial to different parties involved in patient care. The benefit gained from patient navigation programs supports value-based care models that are being implemented across the nation. These programs ensure that patient needs impacting clinical outcomes are being addressed and support hospital financial viability. Although patient navigation is not brand new, programs are now surfacing as they support the goals of the movement towards value-based care.
1Rocque GB, Pisu M, Jackson BE, Kvale EA, Demark-Wahnefried W, Martin MY, Meneses K, Li Y, Taylor RA, Acemgil A, Williams CP, Lisovicz N, Fouad M, Kenzik KM, Partridge EE, for the Patient Care Connect Group. Resource Use and Medicare Costs During Lay Navigation for Geriatric Patients With Cancer. JAMA Oncol. 2017;3(6):817-825. doi:10.1001/jamaoncol.2016.6307
2 Paskett ED, Krok-Schoen JL, Gray DM. Patient Navigation—An Effective Strategy to Reduce Health Care Costs and Improve Health Outcomes. JAMA Oncol. 2017;3(6):825-826. doi:10.1001/jamaoncol.2016.6107