Study: Community navigators can reduce the high cost of 'superusers' in hospital settings

Patients who use high levels of hospital services are a costly burden on the healthcare system, but a new study suggests that pairing them with community navigators can help. 

Researchers from the University of Tennessee Health Science Center and Methodist Le Bonheur Healthcare studied the role community navigators can play in reducing the burden of "superusers" and found that the intervention reduced their encounters by 39%. 

The study paired patients in a group of 159 superusers with community navigators and compared them to a control group of 280 superusers who did not receive the intervention. The researchers examined data from Methodist Le Bonheur's electronic health records from 2013 to 2016, comparing the results pre- and postintervention with navigators. 

Both sets of patients reduced their hospital use during the study period, but the superusers who received the intervention saw an additional 13% decrease in hospital visits and an 8% decrease in total hospital days. The number of days between healthcare encounters increased by 9% in this group, according to the study. 

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The researchers also found decreases in 30-day readmission rates and costs in this group, but the results weren't statistically significant. 

Superusers often have complex socioeconomic needs. Community navigators working directly with these patients can address those needs, researchers said. Navigators can also help patients understand their care journeys and help coordinate their care. 

"The community navigator model is a clinically impactful and potentially cost-saving approach to improving the health and reducing the clinical and financial burden of superusers," the researchers said. 

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Hospitals across the country have adopted a number of tactics to address superusers, especially those who make frequent trips to the emergency room. California hospitals have launched an intensive care coordination program that saved $14 million in superuser costs, while Kaiser Permanente Northwest hospitals have stationed navigators in their ERs to discuss patients' social needs early on in their visit. 

And some hospitals, including Garrett Regional Medical Center in Oakland, Maryland, are hiring patients to serve as navigators. Officials at the hospital say patients are perfect candidates because they’re experienced in navigating the health system and may also lack the financial means to manage their own illnesses.