Patient navigators

by Katie Sullivan

Geisinger Health System has long-used patient navigators, but with the emphasis on follow-up care to prevent hospital readmissions, they play an even greater role in care coordination, Janet Comrey, R.N., a senior consultant for population health at Geisinger in Danville, Pennsylvania, told FierceHealthcare.

Navigators generally contact patients after discharge to review their medications, listen for red flags and help answer questions about recovery. Now, for select populations such as heart failure patients, Geisinger assigns a patient navigator at check-in to give the patient a consistent advocate throughout the care continuum. 

Patients who participated in ProvenHealth Navigator--Geisinger's advanced medical home, a collaborative effort between Geisinger Heath Plan and the Geisinger Clinic--improved their health, according to an analysis of data from more than 80,000 Geisinger Health Plan members collected in the system's practices between 2007 and 2012.

Geisinger saw a 27.5 percent reduction in acute care admissions and a 34 percent reduction in all-cause 30-day readmissions. Emergency department visits remained flat and patients demonstrated improvement in the risk of heart attacks, strokes and damage to the retina of the eye in individuals with diabetes.

Navigators won't just reduce readmissions, they could help save billions of dollars at hospitals, a 2013 Center for Health Affairs report found. Missed patient appointments cost $150 billion a year, the Center noted, indicating that navigation programs can reduce no-show rates.

MetroHealth Cancer Care Center, a 400-physician, 17-site health system in Cleveland, Ohio, found the use of two full-time navigators cut no-shows for radiation patients enough to pay the one navigator's salary in just three months, according to FierceHealthcare. Mercy Health System in Pennsylvania, for example, brought in $5 for every $1 spent on its navigator program, by cutting hospital readmissions and emergency department visits by about a third each.

Hospitals around the country are following suit. In December 2013, 11 hospitals across the country joined in the American College of Cardiology's (ACC) pilot patient navigator program to help support heart attack and heart failure patients most at risk for readmission, FierceHealthcare previously reported. The ACC created the program in response to the Centers for Medicare & Medicaid Services penalizing hospitals for excessive readmissions for heart attack and heart failure.

Patient navigators