The Highmark Foundation will team with Accenture to establish and implement a patient navigation pilot program at two Western Pennsylvania hospitals: St. Vincent Health System in Erie and Allegheny Valley in Pittsburgh. Accenture recently did a study on the success of patient navigation with the Harold P. Freeman Patient Navigation Institute, which developed much of the training that goes into patient navigation programs today. Patient navigation utilizes low-cost, trained community members to connect patients to primary care, has shown to reduce appointment “no-show” rates, decrease inpatient admissions, and reduce unnecessary emergency room visits.
As a result of the study, and Accenture’s corporate citizenship work with the Highmark Foundation, a private foundation and an affiliate of Highmark Inc. that works on a variety of health care issues, both organizations identified two locations to pilot a patient navigation program ahead of the influx of new patients ushered into the health care system under Obamacare.
“Under the new health care reform law, millions of new patients will enter into the health care system. These patients are likely to have a variety of barriers to entry so patient navigation is going to become a bigger issue,” explains Jean-Pierre Stephan, who leads health consumer and services strategy for Accenture, in an interview with CivSource. “Some of these issues are financial barriers, communication barriers including patient education and understanding, or it could be language barriers. There are also basic issues like transportation and child care just to make appointments. Patient navigators help find solutions to those issues so people can get the health care they need.”
Accenture and the Highmark Foundation will work with the hospitals over the one year pilot to create an infrastructure for patient navigation – both locally and within the individual hospitals. As a part of the effort, six patient navigators will be trained, hired and placed within the hospitals, while an additional 10 navigators will be trained, so they can assist when necessary. A third participating hospital is being determined. The Highmark Foundation has committed $254,500 and Accenture will provide pro-bono services in support of the program.
“Patient navigation not only creates a one-on-one connection for the patient, it serves as a low-cost investment that delivers significant value to care delivery,” Stephan says. “Most often the patient navigators are lay people who aren’t clinically trained but have been trained by health care providers.”
The training for the program will come from the models created by the Harold P. Freeman Patient Navigation Institute. Freeman did some of his first work with breast cancer patients in Harlem. Before patient navigators were available the survival rate for patients with breast cancer was approximately 30%. When patient navigators were introduced to help individuals reach their appointments and understand the health care system the survival rate increased to 70%. The institute’s work has caught the eye of metrics oriented organizations like Accenture, as well as other hospitals and health care organizations that often come up against these challenges.
Allegheny and Erie counties were selected for the program partially based on county health rankings; each county had specific factors suggesting a high demand for patient navigation, including limited access to care, quality of care, health disparities, low income, geographic location and racial or ethnic diversity.
“We did a needs assessment before the pilot to look at what the issues in the communities Highmark serves in order to find the places where we thought there would be maximum value,” Stephan notes.
Over the next year, Accenture’s role in the pilot will be to work with the hospitals, Highmark, and the navigators themselves to develop and track success metrics like improvements in no-show rates for appointments. After the year, both organizations will look at ways to expand or improve the program to other providers.