Patient navigators
Local governments can invest in this strategy using State and Local Fiscal Recovery Funds (SLFRF) from the American Rescue Plan Act (ARPA).
- This strategy can help residents access health services. The U.S. Department of Treasury has indicated that strategies that help achieve this outcome are eligible for the use of Fiscal Recovery Funds.
- Investments in this strategy are SLFRF-eligible as long as they are made in qualified census tracts or are designed to assist populations or communities disproportionately impacted by COVID-19.
Program overview
Removing barriers to care and other resources: Patient navigation is a form of individualized case management for individuals who are being screened, treated, or receiving care for complex diseases, such as cancer. Patient navigators help patients access medical care, social services, and other resources that may improve their wellbeing.
Embedded in a healthcare setting: Patient navigation programs are typically operated by hospitals or community-based clinics. Navigators are typically trained healthcare professionals, such as social workers, nurses, or community health workers. Patient navigation services may be provided to all patients receiving cancer care, or they may be targeted toward patients with the fewest resources (e.g., low-income individuals).
Assisting patients in navigating the healthcare system: A primary role of patient navigators is coordinating a patient’s care across their multiple providers, with the aim of ensuring timely access to the appropriate types of care. A patient may meet with their navigator weekly, monthly, or quarterly, depending on the patient’s needs. These meetings may be held over the phone, virtually, or in-person either at the healthcare facility or as part of a home visit.
Addressing other barriers to care: Patient navigators also assist patients with overcoming personal, financial, or environmental barriers to accessing care, such as a lack of transportation or unreliable access to childcare. To address these factors, navigators may connect patients to support services offered by the healthcare system or make referrals to government or community-based organizations.
- Strategies
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Navigating health care systems and services
- Cost per Participant
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Not available
Multiple studies with rigorous designs demonstrate that patient navigation is a well-established strategy for increasing rates of cancer screening.
- This assessment is based on evidence from a 2016 systematic review.
Select the correct staffing mix: Patient navigation programs may differ in the services they provide based on a healthcare system’s goals or the needs of the patients they serve. As such, healthcare systems should hire navigators from professional backgrounds based on those goals and needs, ensuring the navigators can work to the highest level allowed by their professional background. For example, a patient navigation program focused on facilitating access to cancer screening may be best staffed by community health workers, while one more heavily focused on managing patient care may benefit from hiring registered nurses.
Identify funding opportunities: In many cases, patient navigation services are not reimbursable through health insurance. As such, healthcare systems may need to identify alternative funding sources. Project teams may be able to make an internal business case for funding patient navigation services based on the program’s potential for reducing no-shows or improving patient satisfaction. Grants may also be available from the federal government, private foundations, state health departments, or philanthropic organizations.
Build relationships with outside service providers: Often, patients face barriers to accessing care that require services not offered by a healthcare system directly. Healthcare systems should conduct a needs assessment during the program design process to identify the resources that patients are likely to need. This analysis can serve as the basis for outreach to potential partner organizations, like area transportation agencies, social services organizations, voluntary organizations, and more.
Evaluate the program’s effectiveness: By embedding evaluation as part of a patient navigation problem, a healthcare system will be better prepared to assess its effectiveness and identify opportunities for improvement. The American Cancer Society offers a toolkit that includes metrics and recommended evaluation methods for patient navigation programs.