The University of Alabama at Birmingham Comprehensive Cancer Center has received a prominent national Innovator Award from the Association of Community Cancer Centers for its Patient Care Connect Program. The award is given only to ACCC members who are recognized as forward-thinking in creating replicable solutions to improve access, quality and value of patient care. PCCP was selected for demonstrating creativity, innovation and teamwork in delivering cancer care.
Based on the premise that proactive management of distress for cancer patients leads to decreased overall cost and better health care for patients, the multidisciplinary teams at the UAB Comprehensive Cancer Center worked with local oncologists within the UAB Health System Cancer Community Network to emphasize the importance of coordination of care.
“When developing PCCP, we wanted to provide the highest quality of life for people diagnosed with cancer, and while doing that, we wanted to reduce the cost of health care,” said Gabrielle Rocque, M.D., assistant professor in the UAB Division of Hematology and Oncology and medical director of the Patient Care Connect Program. Edward Partridge, M.D., former director of the UAB Cancer Center, is the principal investigator of the program.
The goal of the PCCP was to reduce unnecessary emergency room visits, hospital days and intensive care unit days. The program also aimed to encourage evidence-based clinical pathways and earlier adoption of hospice care, especially reducing the use of chemotherapy in the last two weeks of life.
To accomplish this outcome, a specialized navigation team including trained lay navigators, a supporting nurse manager and other support staff assisted the oncologists in each participating community cancer center or hospital in the community network.
Lay navigators are non medical professionals who go through extensive didactic and practical training ranging from health promotion and communication to data collection and conducting distress screenings. Navigators help to eliminate barriers, link patients with resources to get to appointments, connect patients to providers to address symptoms, and coordinate care between multiple providers. In addition, they ensure timely delivery of care and help patients navigate the health care system, especially assisting with access to care. “One of the novel and central elements of the PCCP was to use trained lay navigators to empower patients to take an active role in their health care,” Rocque said. “Navigators can identify resources, recognize clinical symptoms and triage to the clinical team, understand disease and treatment, and when appropriate and needed, help patients engage in end-of-life discussions with their providers.”
After conducting extensive research over a three-year period with more than 10,000 navigated Medicare patients age 65 and older with a cancer diagnosis, a $19 million total cost savings to Medicare was observed, which amounted to a $781.29 savings per quarter per navigated patient compared to non-navigated patients. Patient satisfaction with the navigation program was high, with 89 percent of navigated patients’ reporting they would recommend the program to another cancer survivor.
“We absolutely believe that integration of lay navigation as part of standard of care improved quality of care and reduced cost to Medicare,” Rocque said. “We also believe navigation will be a key element of future patient-centered, value-based health care redesign.”
The ACCC is the leading advocacy and education organization for the multidisciplinary cancer care team. More than 23,000 cancer care professionals from over 2,500 hospitals and practices nationwide are affiliated with ACCC.