Presenting at the 2022 ASCO Quality Care Symposium, Scott Campbell Worland (Thyme Care, Nashville, TN) explored whether an independent cancer-patient navigation program used in collaboration with a Medicare Advantage plan can show cost savings similar to programs embedded within a single institution or network.

While results have shown that cancer-patient navigation programs tend to reduce total costs of care and improve outcomes, research has focused on programs connected to a single institution or network. Worland and colleagues, in the presentation “Evaluating the effect of a scalable cancer-navigation program on total cost of care,” sought to demonstrate similar results from a program deployed across a variety of settings in New Jersey. They conducted a retrospective observational study with the goal of determining the per-member-per-month (PMPM) total cost of care (TCOC) comparing patients with vs without a navigation intervention that was provided by Thyme Care, a cancer-navigation system. Patients with a cancer-specific ICD-10 code who received systemic antineoplastic therapy were eligible to participate in the program. The team was assigned members of a single MA plan’s population beginning March 2, 2021.

The navigation team coordinated patient care, addressed barriers, facilitated the goals of care discussions, and conducted symptom assessment (both proactive and reactive). The primary outcome was TCOC (excluding part D drug spend). Investigators compared TCOC for patients who received the intervention to a control group of eligible individuals matched using propensity scores taken from clinical and demographic covariates, and they used a repeated measure generalized linear model to estimate the monthly effect of navigation on TCOC. In addition, a Monte Carlo sensitivity analysis was used to provide an upper and lower bound on cost savings.

There was a total of 4,172 eligible members, with 662 in the treatment group (belonging to 25 community practices and 45 hospital-based practices) and 3,510 in the control group (58 community practices, 73 hospitals). PMPM, the mean TCOC dropped $459 more for the navigated group compared to the non-navigated group. The sensitivity analysis suggested a possible range of $209 to $708 PMPM savings in the intervention group.

According to Worland and colleagues, this is the first study to show that a cancer-navigation program can reduce overall costs when used in collaboration with a health plan across a wide geography and range of practice types.

Source

Worland S, Albin M, Dorsey B, et al. Evaluating the effect of a scalable cancer-navigation program on total cost of care. Presented at: the 2022 ASCO Quality Care Symposium; September 30-October 1, 2022; Chicago, IL, and virtual; Abstract 4.