As the move to value-based care and Alternative Payment Models (APMs) continues, oncology patient navigators must become more business savvy and have a full understanding about value-based cancer care metrics. A case in point is Medicare’s Oncology Care Model pilot, the first oncology-specific APM developed by the Center for Medicare & Medicaid Innovation. Data collection and reporting metrics are integral elements of this 5-year pilot program, which seeks to achieve higher quality, more highly coordinated care, and smarter spending.
The challenge: Navigation programs lacked strong evidence-based metrics to demonstrate the impact of navigation on the key areas of quality, coordination, and cost-effectiveness.
The good news: The Academy of Oncology Nurse & Patient Navigators (AONN+) recently released 35 evidence-based metrics in the key categories of patient experience, clinical outcomes, and return on investment.
These metrics were developed using the AONN+ evidence-based Navigation General Certification Domains:
- Community Outreach and Prevention
- Coordination of Care/Care Transitions
- Patient Advocacy/Patient Empowerment
- Psychosocial Support Services/Assessment
- Survivorship/End of Life
- Professional Roles and Responsibilities
- Operations Management/Organizational Development/Healthcare Economics
- Research and Quality Performance Improvement
The metrics were developed so that any cancer program or practice can utilize them, regardless of the navigation model in place. The goal in providing these standard metrics is for cancer programs and practices to use them “as a baseline to prove the efficacy and sustainability of their [navigation] programs.”1 Learn more and access metrics.
Partnering to Advance Value-Based Cancer Care
As oncology providers work to improve care coordination and demonstrate delivery of patient-centered, efficient, quality care, patient navigators can play an important role in establishing connections by partnering with physician practices.
For example, navigators can integrate with physician practices to:
- Increase efficiency and timely access to services by providing comprehensive assessments and referrals to appropriate disciplines
- Reinforce patient education and empowerment through decision aids and patient appointment checklists
- Create standing order sets, physician profiles, pathways, and guidelines
- Increase support for clinicians (ie, provide early discussions about palliative care, goals of care, advance care planning, and pre-habilitation
- Increase contacts with “frequent flyers” to decrease emergency department visits and avoidable admissions
- Provide automatic referrals to financial counseling at time of diagnosis (generate self-referral reports)
