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Patient Navigation Initiative in Care Coordination for Chronic Diseases
The high variability of the quality of care delivery affecting mainly the uninsured, rural populations, ethnic minorities, economically challenged rural populations, and the elderly is a critical issue in the U.S. healthcare system. Chronic illnesses are the most expensive conditions to manage with regard to direct and care costs. The federal government spends a total average of $1.1 trillion annually on chronic diseases, equal to about six percent of the total GDP (Waddill, 2021). Unaffordable insurance, geographic barriers, lack of education, and healthcare facilities expedite the management of chronic illnesses, especially for disadvantaged groups. The Patient Navigator Outreach and Chronic Disease Prevention Act of 2005 is government legislation that curbs variability in the quality of healthcare delivery affecting vulnerable groups.
The Patient Navigator Outreach and Chronic Disease Prevention Act of 2005 was an amendment that overhauled the Public Health Service Act to improve patient outcomes. The amendment is a state initiative to make grants to eligible health organizations to develop and illustrate programs that offer patient navigator services (Seaberg & Norris, 2021). Patient navigators include community health workers, nurses, medical assistants, lay health educators, and health promoters. The main goals of Patient Navigation are to mitigate healthcare disparities and communication challenges and to aid chronically ill patients in overcoming their condition by shaping their attitudes and perceptions. Through care coordination, the Chronic Disease Prevention Act of 2005 can eliminate inconsistency in healthcare quality, improve patient communication, and motivate patients to overcome chronic illnesses.
The U.S. healthcare delivery system is challenged by ethnic and economic disparities causing differentiated health outcomes. Ethnic minorities, mainly black and Hispanic Americans, receive lower quality medical care than white Americans due to financial and ethnic reasons (Seaberg & Norris, 2021). The underserved populations in a changing healthcare environment suffer poor health outcomes. The heightened medicine procedures cause upward spiraling medical care costs, and technology costs affect equal access to quality care. Many chronic infections demand intensive long-term and short-term therapy that is unaffordable to a significant number of the American population (McBrien et al., 2018). Patient navigators help patients get the financial support necessary to manage chronic diseases. The Patient Navigator initiative provides essential service by hiring more social workers to invoke better screening rates, follow-up on diagnosis, and therapy for chronically ill patients.
Apart from economic and ethnic minorities, populations living in rural areas face the risk of poor medical care due to communication and transport barriers. The Chronic Disease Prevention Act of 2005 navigates directly with specific patients through communication to foster good healthcare outcomes. According to Budde et al. (2021), patients need good communication with their health providers to encourage consistent commitment and adherence to medical treatment, therapy, and diagnosis. A patient navigator coordinates communication for patients by setting up health appointments, doctor visits, and medical tests (McBrien et al., 2018). Moreover, patients can access relevant information for appropriate healthcare decisions. People living in rural areas are mostly affected by communication and transport barriers when seeking healthcare services.
Lastly, the Chronic Disease Prevention Act of 2005 aimed at offering emotional support to chronic-ill patients. Chronic diseases are highly likely to inflict an emotional burden on the victims. The navigators role is to explore different ways to address various chronic conditions and patients (Budde et al., 2021). First, navigators should do background research on the patients before engaging them to uphold their cultural and individual values. Good communication skills enable patients to voice their feelings regarding their condition and the service they receive. Unlike medication, talk therapy dedicates interest and support, persuading the patients to voluntarily undertake activities necessary for their recovery. Show compassion and empathy to encourage patients to seek the medical services they require. Navigators should validate their patients to encourage them to overcome their chronic conditions.
Before enacting the Chronic Disease Prevention Act, disparities in healthcare and poor patient communication scourge the American healthcare system; chronic infections demand intensive long-term and short-term therapy that is unequally distributed among the American population. Healthcare disparity in America increasingly became a challenge towards the end of the 19th century, marked by variations in chronic diseases and high disability rates among minority groups. Additionally, health disparities inflicted economic loss leading to approximately $93 billion in medical care excess and $42 billion in losses due to affected productivity and premature death (Seaberg & Norris, 2021). The federal government considered the economic impacts of healthcare disparity when the patient navigation initiative was developed. The Patient Navigator Outreach would enhance equal accessibility of health services in the U.S. to combat chronic diseases.
The implementation of the Patient Outreach program needs financial, material, and human resources. The federal government funds the Navigator programs to ensure distributed initiative coverage. In the largest funding to Patient Navigator Outreach, the government allocates $80 million to facilitate grant awards for three years starting in 2022 (Waddill, 2021). The funding is allocated to sixty eligible organizations spread across all states. The awardees must clearly describe their mission and comply with grant terms and conditions. Community care providers, nurses, and health physicians provide the human resource needed in the patient navigation program.
However, Patient Navigation Outreach is scourged by a lack of reimbursement, poor navigation guidelines, and poor navigator skills. Patient Navigator programs rely on short-term state funding based on a strict budget. In some cases, the reimbursements may fail, or the budget may stretch; hence the outreach programs lose the excess expenditure. Lack of reimbursement affects the outreach programs financial capacity and sustainability to effectively execute their goals. The navigation guidelines do not encompass all the socio-cultural and economic factors affecting healthcare delivery. Navigators lack the social skills to interact with patients from multicultural societies (Seaberg & Norris, 2021). Apart from medical support, health practitioners should offer emotional support in the form of empathy, efficient communication, and listening skills. Navigation essentially involves empowerment and encouragement; hence navigators skills are necessary. Healthcare providers should perform tasks that are not directly related to their job specifications to enhance good patient relations and outcomes.
In conclusion, the Patient Navigator Outreach and the Chronic Diseases Prevention Act of 2005 are government initiatives to mitigate disparity in health care delivery for chronic illnesses. The Patient Navigation Initiative resulted from high inequality in Americas healthcare services due to geographic, ethnic, and economic reasons. An indication of variance in disease incidences and disability affects the minority and rural population. Patient navigation aims to mitigate health inequality, coordinate communication between patients and health providers, and motivate chronic-ill patients to overcome their conditions. Patient navigation is funded $ 80 million after every three years by the federal government. The Patient Navigator Outreach initiative is challenged by a lack of adequate funding, poor navigation guidelines, and poor navigator skills.
References
Budde, H., Williams, G. A., Scarpetti, G., Kroezen, M., & Maier, C. B. (2021). What are patient navigators and how can they improve the integration of care? Web.
McBrien, K. A., Ivers, N., Barnieh, L., Bailey, J. J., Lorenzetti, D. L., Nicholas, D., Tonelli, M., Hemmelgam, B., Lewanczuk, R., Edwards, A., Braun, T., & Manns, B. (2018). Patient navigators for people with chronic disease: a systematic review. PloS one, 13(2), e0191980.
Seaberg, D. C., & Norris, D. (2021). Patient Navigation. In Oncologic Emergency Medicine (pp. 75-81). Springer, Cham.
Waddill, K. (2021). CMS announces historic navigator grant funding for 2022-2024. Health Payer Intelligence.
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