Patient navigators exist largely thanks to grants. While there’s an increasing amount of evidence that navigators can deliver a tangible ROI, there’s no reimbursement code for them.
That’s just fine, according to Mandi Pratt-Chapman, director of The George Washington University Cancer Institute and one of the country’s leading patient navigator researchers.
“I’m of the mind that I would not like to see patient navigation as a billing code,” Pratt-Chapman said during an interview at MedCity ENGAGE this week. “I think that that sometimes has potential to remove the service from those who need it the most.”
With the Rise of AI, What IP Disputes in Healthcare Are Likely to Emerge?
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
In April, the GW Cancer Institute published a list of core competencies for oncology patient navigators. In May, it followed up with free online patient navigator training.
But imagine, Pratt-Chapman said, if some health insurance didn’t reimburse while others did. That could keep patient navigators from those who need it most, she said.
Instead, she wants payers to continue to look at what quality standards health systems should embrace, such as care coordination, medication adherence, that patient understand their treatment and so on. That way, they will look at how patient navigation is wrapped into a payment for overall care.
You can listen to her whole conversation on patient navigators here.
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
Photo: Flickr user Steve Snodgrass
