A lay navigation program for older survivors of cancer can reduce hospitalizations, emergency department (ED) visits, and intensive care unit admissions, resulting in lower health care costs.
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The number of older survivors of cancer in the United States is expected to increase over 10 million in the next 20 to 30 years. Pre-existing conditions and likelihood of comorbidities in this population are high, leading to increased polypharmacy and increased ED visits, hospitalizations, and intensive care unit admissions. Cancer centers are challenged to adapt survivorship care plans to meet the unique needs of older survivors of cancer.
Edward Partridge, MD, primary investigator, University of Alabama Birmingham Health System Cancer Community Network, and colleagues developed the Patient Care Connect Program (PCCP) designed to improve the health, improve care delivery, and lower costs of survivorship care for older survivors of cancer. The program was supported by an Innovation Challenge Grant from the Centers for Medicare & Medicaid Services. PCCP operates in 12 cancer centers across five states.
Since enrollment in the program in 2013, older survivors were not randomized into the program, but rather chose whether or not to partake. Survivors had the option of requesting assistance with distress, which were resolved to survivor satisfaction in 90.7% of cases.
Results of the program were presented at the 2017 ONA Navigation Summit (June 15-17, 2017; Austin, TX).
After 8 quarters from the beginning of enrollment, Medicare costs were reduced by approximately $9000. Hospitalizations were reduced by 75% and significant reductions were also seen in ED visits and intensive care unit admissions.
“Use of PCCP, a navigation system targeted to older cancer survivors, health care costs and health care use declined for navigated patients compared with matched group of comparison patients,” concluded Karen Meneses, PhD, RN, FAAN, in her presentation of the program.
These findings indicate that lay navigation programs can play a role in the health systems transition to value-based care and to meet the need of this growing population.—Zachary Bessette
