Lay Navigators Improve Quality of Cancer Care, Reduce Costs

10/24/17

Integrating lay navigators into a cancer care network reduced hospitalizations by 8% per quarter and accounted for $19 million in savings for Medicare, according to research presented at the Association of Community Cancer Centers (ACCC) National Oncology Conference (October 18-20, 2017; Nashville, TN).

The Patient Care Connect program, which is implemented in the University of Alabama at Birmingham (UAB) 12-institution cancer network, is designed to help patients make appropriate treatment choices, reduce the use of ineffective therapies, and maximize the appropriate use of health care resources. The health care systems are encouraged to achieve the tripe aim.

The lay navigators’ role in this program involves empowering patients to identify resources, recognize clinical symptoms, understand their disease, and engage in end-of-life discussions with their providers, as well as connecting patients to providers to address symptoms and coordinating care between multiple providers.    

“We really wanted to encourage patients to take an active role in their health care,” said Gabrielle B Rocque, MD, assistant professor, division of hematology and oncology, UAB School of Medicine, during her presentation. “Navigators can fix problems for patients, but we wanted to focus on the concept that of empowering patients to learn how to use the system and the resources that are available.”

From March 2013 through December 2016, Patient Care Connect helped navigate approximately 10,000 patients. Individual navigators had an average of 152 patients per quarter.

Long-term results of the program showed a 6% reduction in emergency room visits, 8% reduction in hospitalizations, and 10% reduction in intensive care unit visits per quarter among navigated patients, compared with matched controls.

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This improvement in health care resource utilization resulted in approximately $19 million savings for Medicare across the health system during each year of the program. Additionally, researchers reported that patients engaged in advanced care planning had lower health care utilization at the end of life and lower chemotherapy usage.

Researchers acknowledged that navigator-led distress screening identified a few non-treatment-related issues, such as fatigue, scheduling concerns, and transportation concerns.

“Navigation will be a key element of future patient-centered, value-based health care redesign,” commented Dr Rocque.—Zachary Bessette