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REDUCING BARRIERS, EMPOWERING PATIENTS

How patient navigation will transform healthcare

Overview

What if there was a healthcare solution that paid for itself in just two months while delivering significant health and performance outcomes for an entire year? There is. But you’ve likely never heard of it. A game-changing role ideal for today’s healthcare reform climate, patient navigation is poised to become a household word over the next decade. It can drive clinical transformation, provide meaningful careers to put people back to work, and reshape healthcare at a pivotal time.

Assisting provider and payer organizations—especially those serving Medicaid populations—to develop patient navigation programs and train patient navigators, Accenture is seeing the impact first hand. By focusing on necessary but non-clinical tasks, patient navigators reduce the burden of overwork and help improve quality of care while driving more rapid movement through the healthcare system, generating revenue and saving money via new efficiencies.

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Background

Patient navigation originated in Dr. Harold Freeman’s work over two decades ago to improve cancer mortality rates among disadvantaged populations in Harlem. With patient navigation and access to screening, the Harlem Hospital Center saw five-year survival rates in breast cancer increase from 39 to 70 percent.1

Patient navigation is rooted in a simple premise. If barriers to timely healthcare solutions and access are eliminated, and patients are supported throughout the healthcare continuum, healthcare outcomes will improve. These barriers are often broader than most realize. They include more commonly discussed issues such as financial constraints and lack of medical insurance. Yet they also include less obvious, but equally paralyzing, factors. These are the emotional, cultural, communication and logistical barriers that cause people to disengage from the healthcare system, neglecting preventive care or chronic disease treatment. Simply put, the best healthcare advances mean nothing if a patient misses her appointments because she doesn’t have a ride or a babysitter.

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1 Harold P. Freeman, MD and Rian L. Rodriguez, MPH, History and Principles of Patient Navigation, Cancer, August 1, 2011.

Analysis

The compelling story of a regional medical center primarily serving Medicaid patients demonstrates the value of patient navigation as a valuable healthcare solution in today’s complex environment.

To address the high cost in health outcomes, wasted resources and lost revenue associated with missed radiation appointments for head and neck cancers, the hospital decided to begin a patient navigation program to help patients keep their appointments. Trending data indicate that not only did the service pay for itself in just over two months; overall appointment no-show and cancellation rates dropped from just over 11 percent to 8.36 percent as a result of this intervention. A similar program at a renowned academic medical center shows the same trend.

Patient navigation is also a timely healthcare solution for the Medicaid environment. As states expand Medicaid rolls as a result of healthcare reform and the Affordable Care Act, patient navigation can support the legislation’s focus.

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Recommendations

A cost-effective resource for community or payer organizations, provider facilities, in at-home care settings, and organizations serving Medicaid populations, lay patient navigators can connect the care team around the patient and augment the work of physicians, nurses, care managers and social workers. They can help to:

  • Improve quality of care.

  • Reduce no show rates.

  • Reduce emergency room utilization.

  • Increase Medicaid enrollment.

  • Increase patient satisfaction.

  • Increase physician and nurse satisfaction.

The patient navigation role has widespread resonance. For disadvantaged patients, patient navigators forge person-to-person connections on a patient’s own terms—connections that have historically been missing for many. For the healthcare community, patient navigators are a lower cost investment that delivers much-needed health and business outcomes. For communities, patient navigation provides opportunities to put unemployed people or retirees who want to make a difference back to work in a growing sector while improving health quality and access for many.

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Video Series

Learn how a new job in healthcare—the Patient Navigator—not only empowers patients to overcome barriers to care, but reveals a positive return on investment and pays for itself in the first year.

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