The Michigan Value Collaborative

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

Tag: MVC (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

How Michigan can be the best in CHF readmissions

Deby Evans

Deb Evans is the MVC Site Engagement Manager

Last November, the Michigan Value Collaborative (MVC) launched its goal to work together to be number one in the country for CHF readmissions. MVC hospitals have shared best practices and challenges with one another through workgroups, toolkits and blogs to collaboratively meet this goal.  In addition to learning from one another, there is information to be gained in how hospitals outside of Michigan are addressing readmissions.

A report from the Commonwealth Fund titled “Reducing Hospital Readmissions: Lessons from Top-Performing Hospitals” identified quality improvement strategies implemented with measurable impacts on reducing readmissions. One of the hospitals studied is in Utah, which currently has the lowest CHF readmission rate in the nation according to CMS Hospital Compare.  According to the study, successful quality improvement strategies included incorporating evidence-based practice into daily protocols, standardizing procedures along with information gathering, providing feedback and supporting clinical decisions through electronic information systems.

Specific initiatives underway include:

Providing clinically excellent patient care with a focus on patient safety. Doing this leads to a fall in readmission rates, improvement in quality measures and savings are realized as a byproduct.

Using information technologies as tools that improve quality, integrate care and ease patient transitions.

Early involvement of case management and discharge planning.

Targeting high risk patients and ensuring frequent communication across the whole care team.

Teaching patients and families how to manage their conditions.

Maintaining a life-line with high risk patients after discharge.

Aligning the efforts of hospital and community providers to ease transitions across care settings.

The authors noted that hospital environments played a role in each facility’s ability to reduce admissions. Specifically, the success of the initiatives were influenced by policy environment, local health care markets, association with an integrated health system and the priorities set by hospital leaders.

Many of the programs implemented by the top performing hospitals are similar to initiatives discussed by the MVC CHF readmission workgroup. For more information on the workgroup or toolkit, please contact Deby (debevans@med.umich.edu ) or Abeer (abeery@med.umich.edu ).

Read the full article here http://www.emergingrnleader.com/wp-content/uploads/2012/08/1473_SilowCarroll_readmissions_synthesis_web_version2.pdf

 

 

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