CancerX Moonshot and the Role of Digital Patient Navigation in Reducing Financial Toxicity

The Need for Patient Navigation and the CancerX Moonshot

Patients with cancer and their families are often under-equipped to navigate the high costs and complexities of their treatment after a diagnosis, resulting in poor clinical and financial outcomes. Patient experience data from Cancer Support Community’s Cancer Experience Registry of over 4000 patients indicates that 76% of patients do not feel knowledgeable about the financial impact of cancer treatment options available to them, that 33% of patients depleted their life savings to pay for medical costs after a cancer diagnosis, and that 29% of patients experienced delays or barriers to accessing cancer care or treatment.

Patient navigation has emerged as a pathway to address these information gaps and a critical tool for health system use in providing equitable access to precision cancer care, reduced patient financial toxicity, and improved cancer outcomes. Patient navigation services are a key feature of White House Cancer Moonshot goals to facilitate community-based healthcare access and improved cancer patient and caregiver experience. These services are also newly reimbursable under the Centers for Medicare and Medicaid Services (CMS) 2024 payment rule aimed at advancing equitable access to whole-person care.

The Impact of Patient Navigation Programming for Patients and Health Systems 

Patient navigation services are crucial in helping patients and their families manage the medical and financial burdens associated with cancer treatment. However, healthcare staffing and resource shortages mean we have fewer healthcare providers and navigators supporting patients with complex health-related social needs and patients who have more advanced and costly cancers.

Resource-constrained health systems can leverage digital solutions to standardize and prioritize the delivery of patient navigation services in support of equitable patient health, cost, and quality-of-life outcomes. Digitally-enabled patient navigation programs also produce real-world cost and healthcare utilization improvements for health systems.

Research shows that in one program where patients were routinely screened with a digital distress screener, and subsequently connected with supportive services within one year following screening, patients had 57% fewer emergency department visits, a 50% decrease in hospital admission days, and were up to 4.2 times more likely to access integrative medicine department services, patient and family counseling services, and financial counseling.

Finally, digital solutions can augment navigation programs to alleviate administrative burden for program staff and to scale the programs so that health systems can provide equitable access to high-quality navigation for more patients.

Despite the benefits of digital patient navigation programming, cost is a significant barrier to investment. CancerX set out over the last year to build resources that would help health systems quantify and maximize the return on investment (ROI) associated with digital patient navigation programming.

Introducing the CancerX Digital Navigation ROI Calculator and Digitally Enabled Patient Navigation Blueprint

To support the implementation of digitally-enabled patient navigation programs, CancerX has produced a set of resources for health system leadership and cancer care navigators. These resources support the design and implementation of digital navigation programming to improve equity and reduce out-of-pocket costs for patients across their cancer experience.

The Digital Navigation ROI Calculator supports health system decision making by quantifying the impact of digital patient navigation programs on the healthcare resource use measures that matter to their health systems. This customizable calculator gives decision makers a fuller picture of the potential cost impact of digital patient navigation within their health system.

The Digitally Enabled Patient Navigation Blueprint supports standardized, scalable, and sustainable digital patient navigation across cancer care delivery systems with varying resource levels. The Blueprint provides instruction on how to adapt existing health technology platforms to support patient navigation. The Blueprint also provides a standardized workflow for digital patient navigation and instruction on how patient navigators should document and bill for their services, ensuring reimbursable, sustainable programming.

The resources were developed by the project team supporting CancerX’s inaugural evidence generation project including 24 organizations focused on the creation of precompetitive solutions to improve equity and reduce financial toxicity for patients with cancer.

 Deployment of Digital at Scale for Improved Patient Navigation and Reduced Financial Toxicity

The high costs of cancer treatment can exacerbate health disparities, undermine tailored treatment plans, and produce negative health and quality of life outcomes for patients. By one 2020 estimate, the average cost of medical care and prescription drugs across all cancer sites was more than $42,000 in the year following a cancer diagnosis. Both health systems and patients need support establishing and engaging in patient navigation programs to ensure effective and equitable cancer care that does not cause financial distress.

Clinical decision-makers can start using these freely available CancerX resources today to develop digital strategies and financial navigation programs that produce equitable access to cancer treatment for patients in their catchment and reduce out-of-pocket costs for patients across their cancer journey.

Authors:

• Sarah Sheehan, Program Lead, CancerX, Digital Medicine Society (DiMe)
• Jacob Centra, Research Lead, DiMe
• Abigail Baldwin-Medsker, Senior Director, Emerging Digital Programs, Memorial Sloan Kettering Cancer Center
• Seth Berkowitz, Director Strategic Healthcare Partnerships, The Leukemia & Lymphoma Society
• Karen Costello, Senior Director Helpline, Lead Navigation Strategies, Cancer Support Community
• Cate O’Reilly, Vice President of Fund Development, Cancer Support Community
• Smit Patel, Director, Digital and AI, DiMe
• William A Wood,  Professor of Medicine, University of North Carolina
• Corinne R. Leach, Director, Digital Innovation – Research Excellence, Center for Digital Health, Moffitt Cancer Center

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