Lay Navigation Associated With Lower Medicare Costs, Health Care Use

The Patient Care Connect Program helps navigate patients through a often-complex health care system.
The Patient Care Connect Program helps navigate patients through a often-complex health care system.

Lay navigation among older patients with cancer was associated with reduced costs to Medicare and lower health care use from 2012 through 2015, a study published in JAMA Oncology has shown.1

In the Patient Care Connect Program, lay navigators support patients with cancer from the time of diagnosis through survivorship to end of life by empowering patients to engage in their health care and navigating them through the complex health care system.

Previous research has demonstrated that navigation programs can improve access to care, enhance coordination of care, and overcome barriers to receipt of high-quality care; however, limited data on the financial impact of implementing a lay navigation program exist.

To assess the implications of lay navigation on health care spending and resource use among geriatric patients with cancer, researchers compared quarterly changes in the mean total Medicare costs and resource use between 6214 navigated and 6214 matched non-navigated patients who received care in the The University of Alabama at Birmingham Health System Cancer Community Network. This health care network included 2 academic centers and 10 community cancer centers across Alabama, Georgia, Florida, Mississippi, and Tennessee.

Results showed that the mean total costs decreased by $781.29 more per quarter per navigated patient compared with the non-navigated group, which translates to an estimated $19 million reduction per year across the network.

Researchers also found that inpatient costs had a mean total quarterly decline of $294 per patient and outpatient costs decreased by $275 per patient. Compared with the non-navigated patients, navigated patients had emergency department visits, hospitalizations, and intensive care unit admissions decrease by 6.0%, 7.9%, and 10.6%, respectively, per quarter (P < .001).

The authors concluded that lay navigation programs should be expanded as health systems transition from volume-based care, or fee-for-service, to value-based health care.

Reference

1. Rocque GB, Pisu M, Jackson BE, et al. Resource use and Medicare costs during lay navigation for geriatric patients with cancer. JAMA Oncol. 2017 Jan 26. doi: 10.1001/jamaoncol.2016.6307 [Epub ahead of print]

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