Real-World Evidence Supports Patient Navigation in Cancer

February 2020, Vol 11, No 1 | Payers’ Perspectives In Oncology | Including ASH 2019 Highlights

Patient navigation is an increasingly recognized component of high-quality, patient-centered care. However, patient navigation in cancer programs is limited, often because of uncertainty about sustainable financial models to support these programs and defining the scope of practice. To demonstrate the benefits of patient navigation programs, researchers analyzed 5 real-world case studies (Kline RM, et al. J Oncol Pract. 2019;15:585-590).

Evidence showed that patient navigation increased patient retention in cancer programs. A pilot program at a northern California healthcare organization, for example, tested the differences in patient retention between patients with breast cancer for whom the patient navigation program was initiated earlier and later in the diagnostic continuum. The results showed that 35% fewer patients were lost to other health systems if they were in the patient navigation program from the point of a suspicious finding. A study of patients assisted by nurse navigators in the University of Pennsylvania Health System showed that these patients were 10% more likely to stay for treatment compared with those not in the program.

Patient navigation also increased patient and physician demands. The Sarah Cannon program, which is part of the Sarah Cannon Cancer Institute, had 59% growth in patients in the patient navigation program between 2017 and 2018, which correlates with increased patient volumes. In addition, loyalty among surgeons participating in the programs increased from 70% to >90% of surgeries performed when a surgeon used a nurse navigator.

Patient navigation was also associated with a reduction in unnecessary resource utilization, as demonstrated by the University of Alabama’s Patient Care Connect program. The percentage of emergency department visits, hospitalizations, and intensive care unit admissions declined by 6%, 7.9%, and 10.6% more per quarter, respectively, than the matched control patients. As a result, the costs for patients in the patient navigation program declined by $781.29 per quarter more than in the control group, resulting in an estimated 10:1 return on investment.

In addition, in a fee-for-service payment model, patient navigation was shown to generate financial benefits by significantly decreasing patients moving to other health facilities for their cancer care, based on data from the University of Pennsylvania, the Sarah Cannon Cancer Institute, and the northern California healthcare organization.

Key issues that remain for patient navigation programs include identifying what processes can best match navigator duties to specific patient needs and alternatives when navigators are unable to resolve patient concerns.

“Because evidence supports the importance of cancer PN [patient navigation] for patients and the financial benefit to practices and health systems, changes may be on the horizon that could transform PN from an intervention that a cancer practice has to offer to an intervention that a cancer practice wants to offer. This could certainly be described as a win-win-win for patients, practices, and providers,” concluded the researchers.

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