The Biden Cancer Moonshot marked the one-year anniversary of CMS finalizing six navigation service billing codes by sharing reported outcomes from a variety of navigation programs.
Tens of thousands of navigation claims have been processed since Jan. 1, for approximately 350 Medicare beneficiaries per month, according to a Nov. 26 news release from the White House.
Here are 11 things to know about the latest navigation outcomes:
- After implementing navigation services, New Hyde Park, N.Y.-based Northwell Health Cancer Institute reported a more than 60% decrease in wait times for surgical oncologist appointments between January and September.
- Fort Myers, Fla.-based Florida Cancer Specialists & Research Institute reported a 40% reduction in emergency room visits for qualified, high-risk patients after implementing navigation services in February.
- West Orange, N.J.-based RWJBarnabas Health and New Brunswick, N.J.-based Rutgers Cancer Institute, partnered on a "one-stop shop" for patients to access oncology care and connection to supportive services, including a patient navigator.
- Meena Seshamani, MD, PhD, deputy administrator and director for the Center for Medicare, highlighted two important calls to action:
- Navigation codes can be applied to high-risk conditions without a definitive diagnosis, meaning patients with a positive screening test can be referred to navigation services for diagnosis and follow-up care.
- State-level programs can adopt coverage of navigation codes for Medicaid patients.
- Navigation codes can be applied to high-risk conditions without a definitive diagnosis, meaning patients with a positive screening test can be referred to navigation services for diagnosis and follow-up care.
- The Indian Health Service partnered with the Tucson-based University of Arizona to provide specialized training for staff to deliver navigation services for the agency's CRC screening program.
- The Health Resources and Services Administration proposed new guidance for coverage of navigation services for breast and cervical cancer screening.
- The Department of Veterans Affairs developed navigation tools to be piloted through 2025 in 12 of the 18 Veterans Affairs regions.
- The President's Cancer Panel, an independent group tasked with monitoring the National Cancer Plan, has released a report highlighting ways to utilize navigation tools and technology to achieve cancer care equity.
- The Patient Advocate Foundation established 2,850 grants of $300 each to cover out-of-pocket costs for navigation services.
- The National Minority Quality Forum will launch an early detection study in 2025 for 25,200 participants in marginalized communities.
- The American Cancer Society and National Consortium of Breast Centers will expand educational offerings for navigators and oncology professionals.