The Michigan Value Collaborative

Helping Michigan hospitals achieve their best possible patient outcomes at the lowest reasonable cost

Tag: education (page 1 of 2)

Patient Navigators and Their Value to Hospital Care

Abeer Yassine

Abeer is the MVC Hospital Engagement Associate

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

Recognizing the Value of Palliative Care as Part of Comprehensive Health Care

Abeer Yassine

Abeer is the MVC Hospital Engagement Associate

Palliative care programs aim to maximize patient comfort, relieve distress, and provide support to patients and their families.  Patients do not need to be diagnosed as terminal to benefit from palliative care. Studies have found palliative care programs increase patient satisfaction with treatment while decreasing costs.  As a result, health care organizations around the nation are working on introducing or strengthening palliative care programs to help advocate for more holistic patient care beyond the chronic illness.

According to America’s Care of Serious Illness: 2015 state-by-state report card on access to palliative care in our nation’s hospitals by the National Palliative Care Registry, Ohio has a 2015 Report Card letter grade of A, compared to Michigan’s B grade.1 In this report, hospitals were given a letter grade of A-F based on its access to palliative care programs.Despite its benefits, physician referrals to palliative care are low – only 13% of cardiac patients are referred to palliative care.2  To improve access, some outpatient clinics in Ohio have partnered with community-based programs specializing in palliative care.  In addition to providing care to the patient, the community-based program offers education to clinicians on what palliative care entails and how to refer patients.

Similarly, a recent study at John Hopkins Medical Institution (JHMI) explored the cost-effectiveness of its existing palliative care program to determine whether an expansion was warranted. By using admissions data, JHMI studied the financial outcomes of their palliative care program on patient care over the course of 13 months. The impact of the palliative care program was significant, as there was a total positive financial payoff of nearly $3.5 million for the health system. This financial impact emphasizes that value-based program models focusing on patient-centered care not only benefit the patient experience but also benefit health system finances. More about this study and the methods used can be found here: http://ascopubs.org/doi/full/10.1200/JOP.2016.014860

Nonetheless, palliative care programs across the nation are each unique and beneficial in their own ways. Some health systems have taken a community approach to palliative care, while others seek to strengthen their programs through clinical fellowships, consultation programs, and expansion. Following the CHF workgroup last month, the Coordinating Center created a Palliative Care and CHF brochure that highlights different facts, figures, and initiatives related to palliative care that can be helpful for hospitals interested in refining or expanding their respective programs. This can be found in the MVC Registry under Resources. For more information on the brochure or workgroup, please contact Deby (debevans@med.umich.edu) or Abeer (abeery@med.umich.edu).

Also keep an eye out for future blog posts highlighting hospitals in Michigan that have exceptional palliative care programs and emphasize a positive patient experience!

 

1 National Palliative Care Registry. America’s Care of Serious Illness: 2015 state-by-state report card on access to palliative care in our nation’s hospitals. https://registry.capc.org/wp-content/uploads/2016/01/2015-State-by-state-Report-Card.pdf

2 National Palliative Care Registry. How we work: Trends and Insights in Hospital Palliative Care https://registry.capc.org/wp-content/uploads/2017/02/How-We-Work-Trends-and-Insights-in-Hospital-Palliative-Care-2009-2015.pdf

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