The greater Cleveland area is widely regarded as a center of healthcare excellence. Home to the world-renowned Cleveland Clinic, the region also benefits from the services of nearly 35 other hospitals.i This critical mass of healthcare expertise and infrastructure, while providing the region with unsurpassed healthcare options, can seem daunting to high-risk patients who lack the knowledge to find the treatment they need.
To address this issue, MetroHealth, which ranks third in the US News & World Report’s 2014 review of regional hospitals in greater Cleveland, introduced an innovative patient navigation program. Designed to help vulnerable Clevelanders overcome what can be significant barriers to obtaining needed care, the program assigns a patient navigator to blaze a trail for them across the region’s increasingly complex medical landscape. By guiding patients past any financial, logistical, emotional, cultural or communications-related roadblocks, navigators help patients obtain the care they need when they need it. What’s more, the patient navigation program not only helps patients in Cleveland obtain the treatment they need, it also quickly pays for itself, rapidly generating a positive return on investment (ROI) for the healthcare provider.
Originally developed by Dr. Harold Freeman in Harlem more than 20 years ago, patient navigators help the highest-risk patients with diseases like cancer, diabetes and sickle cell anemia. Providers use them to help patients gain access to quality care on a timely basis. By moving patients from an unmanaged to a managed state, navigators help them achieve better care and resulting better health—at lower costs.
MetroHealth’s yearlong pilot program paid for itself in just over two months and reduced patient no-show and cancellation rates by 3% compared to a control group. One example of its effectiveness: In its first few months, the program cut the number of “no-show” appointments for cancer patients to such a degree that the savings equaled a navigator’s yearly salary. Each full-time navigator contributes $150,000 to MetroHealth’s bottom line annually. By extrapolating from these results, it becomes clear that having just two full-time navigators who worked across seven priority areas could yield a potential revenue increase of between $1.5 and $2 million in a year.
In the accompanying video, cancer survivor and Cleveland resident Alicia, reveals that her first emotions after being diagnosed with breast cancer, were fear and discouragement. With children at home and no health insurance, she felt lost until she met her patient navigator and joined MetroHealth’s BREAST/Amigas program. Focused on improving breast health among Cleveland’s under-insured Hispanic and African American women, the program offers free education, clinical breast exams and mammograms at convenient community locations. Her patient navigator helped her overcome her growing fear and anxiety by offering hope, knowledge and friendship, identifying the organizations she should contact for support and suggesting other steps she could take. By guiding her to critical care in the early stages of her journey Alicia is confident that her MetroHealth System patient navigator saved her life.
i. US News & World Report 2014 ranking of regional hospital, Greater Cleveland area.
To learn more about how patient navigators help patients through financial, logistical, emotional, cultural and communications barriers, read Simple Solutions to Complex Problems: How Patient Navigation Brings the Human Touch to Healthcare.