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J Oncol Pract. 2019 Sep 11:JOP1900230. doi: 10.1200/JOP.19.00230. [Epub ahead of print]

Patient Navigation in Cancer: The Business Case to Support Clinical Needs.

Author information

1
Centers for Medicare & Medicaid Services, Baltimore, MD.
2
University of Alabama at Birmingham, Birmingham, AL.
3
Centers for Disease Control and Prevention, Atlanta, GA.
4
Atrium Health, Charlotte, NC.
5
Sutter Pacific Medical Foundation, Santa Rosa, CA.
6
George Washington University Cancer Center, Washington, DC.
7
Sarah Cannon Cancer Institute, Nashville, TN.
8
University of Pennsylvania, Philadelphia, PA.

Abstract

PURPOSE:

Patient navigation (PN) is an increasingly recognized element of high-quality, patient-centered cancer care, yet PN in many cancer programs is absent or limited, often because of concerns of extra cost without tangible financial benefits.

METHODS:

Five real-world examples of PN programs are used to demonstrate that in the pure fee-for-service and the alternative payment model worlds of reimbursement, strong cases can be made to support the benefits of PN.

RESULTS:

In three large programs, PN resulted in increased patient retention and increased physician loyalty within the cancer programs, leading to increased revenue. In addition, in two programs, PN was associated with a reduction in unnecessary resource utilization, such as emergency department visits and hospitalizations. PN also reduces burdens on oncology providers, potentially reducing burnout, errors, and costly staff turnover.

CONCLUSION:

PN has resulted in improved patient outcomes and patient satisfaction and has important financial benefits for cancer programs in the fee-for-service and the alternative payment model worlds, lending support for more robust staffing of PN programs.

PMID:
31509483
DOI:
10.1200/JOP.19.00230

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