Using community-engaged methods to develop a study protocol for a cost analysis of a multi-site patient navigation intervention for breast cancer care

Abstract

Background Patient navigation is an evidence-based intervention for reducing delays in oncology care among underserved populations. In order to address the financial sustainability of this intervention, information is needed on the cost of implementing patient navigation in diverse healthcare settings. Because patient navigation programs and care settings are highly variable, this paucity of cost data creates difficulties in identifying best practices and decisions about the feasibility of implementing navigation programs within a health care system. One barrier to collecting these cost data is the lack of assessment tools available to support patient navigation programs. These tools must be relevant to the wide variety of navigation activities that exist in health care settings, and be flexible enough to collect cost data important to stakeholders in fee-for-service and value-based care environments. Methods and results We present a novel approach and methods for assessing the cost of a patient navigation program implemented across six hospital systems to enhance timely entry and uptake of breast cancer care and treatment. These methods and tools were developed in partnership with breast oncology patient navigators and supervisors using principles of stakeholder engagement, with the goal of increasing usability and feasibility in the field. Conclusions This methodology can be used to strengthen cost analysis and assessment tools for other navigation programs for improving care and treatment for patients with chronic conditions. Trial registration NCT03514433

Perspectives on supporting Veterans’ social needs during hospital to home health transitions: findings from the Transitions Nurse Program

“…THRIVE, a clinical pathway developed to support individuals insured by Medicaid in the transition from community hospital to HHC, includes community health workers who address patients’ social needs and has shown preliminary reductions in 30-day readmission and emergency department use compared to baseline [ 8 ]. Industry partnerships continue to grow with SDOH information exchanges working with health plans, state governments, and healthcare systems, such as ChristianaCare’s partnership with Unite Us, to provide geographically tailored social needs resources for patients [ 25 – 27 ]. Such innovations hold promise for their ability to be adapted and piloted to create a robust VHA pathway to detect and address Veterans’ social needs during care transitions.…”