Navigation Program Could Reduce Cost of Care

By Leah Lawrence - Last Updated: October 18, 2022

Use of a cancer-navigation program reduced overall costs when deployed in collaboration with a health plan across a wide geography and range of practice types, according to a study presented at the 2022 ASCO Quality Care Symposium.

Researchers led by Ravi B. Parikh, MD, MPP, FACP, Assistant Professor of Medicine and Medical Ethics and Health Policy at the University of Pennsylvania, found a reduction in $429 per health plan member per month (PMPM) when patient navigation services were made available compared with no navigation services.

The researchers conducted a retrospective observational study of 4,172 eligible member of a single Medicare Advantage plan in New Jersey. The state has a wide variety of practice settings, from small community practices to major academic medical centers. About 16% of the patients with cancer received navigation assistance.

Parikh and colleagues looked at the PMPM total cost of care (TCOC) difference between patients with and without a navigation intervention provided by ThymeCare, a technology-enabled virtual cancer-navigation platform.

A team staffed by lay health care workers and nurses coordinated care, addressed barriers to care, facilitated goals of care discussions, and conducted proactive and reactive symptom assessment. The primary outcome of the study was TCOC excluding part D drug spend.

The mean TCOC declined $429 more PMPM for the group that received navigation assistance compared to the group that did not receive navigator assistance. A separate analysis suggested a plausible range of $209 to $708 savings PMPM in the navigation-assisted group. The greatest impact in cost savings was associated with inpatient visits, which is what was expected based on prior studies and the fact that many of the program’s interventions focused on reducing acute care use.

“New and more effective therapies for cancer are constantly being introduced. Despite many of these advances, care coordination can often be fragmented, education about the best care options can be lacking, and access to care isn’t always easy. We’re missing some of the foundational components that enable whole person care. Navigation can fill these gaps, and we believe this study helps to chart a path forward on how to expand cancer navigation to help more people,” Parikh said.

Commenting on the study, ASCO Chief Medical Officer and Executive Vice President Julie R. Gralow, MD, FACP, FASCP, said, “Patient navigators play a vital role in helping patients with cancer move through various organizational and other challenges related to their care. Now, we have evidence on a larger scale than has ever been studied before, thanks to the use of a virtual navigation program, that in addition to the tremendous social services navigators offer, they can also help patients save significantly in total costs of care.”

 

Reference

 Evaluating the Effect of a Scalable Cancer-Navigation Program on Total Cost of Care 

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