How Patient Navigation Can Cut Costs and Save Lives
Mary*, a patient at MetroHealth System in Cleveland, Ohio, was not sure how to move forward when her throat cancer recurred after radiation and chemotherapy treatment. Her options were narrowing and there was a point at which she considered not moving forward at all with treatment. But then, Mary decided to contact a patient navigator for help, and what started as a counseling call became a new lifeline. Mary's patient navigator helped her understand her treatment options, coordinated and attended her appointments and helped renew Mary's will to move forward.
MetroHealth began its patient navigation program to help patients, especially underinsured ones, through the barriers that often impede their ability to obtain care. These barriers are not just financial; they can also be logistical, emotional and even cultural. And in today's healthcare environment, these barriers often go unaddressed. For instance, patients may not understand their course of treatment, where to go for treatment or even how they are going to get there. They may worry about who will watch their children and how they will pay for their prescriptions. Without answers to these basic questions, some patients give up.
With their expertise in handling patients' needs and their understanding of the healthcare process, patient navigators can provide those answers and ensure that patients are getting the care they need. Navigators work directly with patients and their families, building a trust-based relationship rooted in an understanding of the patient's community, culture, values and lifestyle. With that knowledge, patient navigators generally can assist patients with the logistics of their care: from managing appointments, completing medical forms and exploring funding options to making arrangements for transportation to appointments and securing childcare services during times of treatment.
MetroHealth patient navigators can be called upon to help patients in a variety of ways. They can do everything from reminding patients to take their prescriptions to providing even the most basic information, such as where to get their parking validated. In Mary's case, her patient navigator not only accompanied her to her medical treatments, but also helped her obtain furniture when she moved.
Patient navigation also helps to improve performance outcomes. When a patient misses an appointment, it is detrimental to his or her treatment plan. Additionally, every no-show or cancellation in the cancer specialty area costs money — for MetroHealth, it is nearly $1,500 per appointment.
In fact, a six-month Accenture-MetroHealth study shows that the patient navigator program is providing a positive return on investment in a number of ways:
- Patient navigation support helped reduce no-show and cancellation rates by 3 percent compared to a control group of patients.
- The revenue generated by the program paid for the salaries of two full-time patient navigators in just over three and a half months.
- Each full-time navigator added $150,000 in additional hospital revenue per year.
- Extrapolating from these results, two full-time navigators across seven high-cost priority areas, such as head and neck cancers, colon cancer and diabetes, could yield approximately $2.1 million per year.
In addition to performance improvements, patient navigation can improve health outcomes. This is reflected in data from Dr. Harold Freeman's groundbreaking work; he pioneered patient navigation more than two decades ago to improve cancer survival among disadvantaged populations in Harlem. With patient navigation and access to screening, the Harlem Hospital Center saw five-year survival rates in breast cancer increase from 39 percent to 70 percent.
These findings showcase the huge impact that patient-navigation support could have if implemented widely, especially in large health systems. For example, Accenture has partnered with Dr. Freeman and the Patient Navigation Institute (PNI) since 2009 to drive the capacity and scale of training patient navigators through online curriculum that arms them with the skills to succeed. To date, Accenture and PNI have trained 120 navigators in Cleveland. And through grants and pro-bono services, Accenture is helping PNI expand the program to 35 locations across the United States over the next three years, resulting in 7,500 new patient navigators.
But as health systems integrate patient navigators in their healthcare teams, they must do more than just put navigators in the care setting and expect results. With the appropriate needs assessment to identify priority areas, the larger the patient navigation program, the greater the potential return. This way, healthcare organizations can identify the right patient navigation program to benefit everyone — from payers and providers to patients like Mary.
*Patient's name has been changed to protect her privacy.