Patient navigation: Revenue opportunities for hospitals

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Patient navigation could help save billions of dollars at hospitals, according to a recent report from the Center for Health Affairs. Missed patient appointments cost $150 billion a year, the Center noted, indicating that navigation programs can reduce no-show rates.

For instance, at New York's Lincoln and Mental Health Center, the no-show rate for colorectal cancer patients dropped from 67 percent to 10 percent, according to the report.

Just as complex as healthcare is, so is the definition for patient navigation, a model that has been developing for the past two decades but is still in its infancy in implementation. The Center for Health Affairs clarifies what a patient navigator is--a professional (clinical or lay person) dedicated to individualized patient care.

Although definitions typically revolve around duties, such as scheduling appointments and offering general encouragement to patients, the Center notes that "navigation is not about a set of specified services," but rather "recognizing barriers for individual patients and identifying strategies to eliminate them."

In addition to cutting no-show rates, navigation programs can offer other revenue opportunities for hospitals. At St. Mary's Quality Care Nurse Navigator Program in Indiana, a three-person team, consisting of nurse navigator, case manager and a social worker, helped to cut readmission rates by 13 percent, CEO Janice Ryba told the (Chicago) Post-Tribune.

Gina Harris, one of the six advanced practice nurse navigators at the hospital, said, "Patients even call me at home on weekends. We're the stable force throughout their stay and after."

Comparing her job to a ship captain steering a vessel through troubled waters, Harris and other navigators each average 30 patients at a time and meet daily to explain medical terminology to the patients and family, connect them with community social services and locate free or discounted medications.

The nurse navigation program offers a "glimpse into the future of healthcare," that focuses on continuity of care, particularly after discharge, according to the newspaper.

For more information:
- check out the Center for Health Affairs' report (.pdf) and statement
- see the Post-Tribune article

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