Care Coordinators, Patient Navigators: Emerging Roles in Healthcare

We often note nurse care coordinators and patient navigators in our stories here at Physicians Practice, but we seldom delve into what exactly they do, who they are, and how and if they might be beneficial to your practice.

If you are exploring the possibility of participating in new health reform initiatives such as accountable care organizations (ACOs) or patient-centered medical homes, it’s time to pay attention to these emerging roles.

Here’s why: These new models of care will reward you based on your ability to improve care quality at reduced cost. That means you’ll need to increase patient engagement, follow-up with patients more often, and monitor them more closely.

For most practices, that’s a lot to take on. It’s likely your employees are already maxed out when it comes to daily workload.

As a result, if participating in these new models of care, you may need to add new employees to your team who can take on these additional responsibilities. Care coordinators and patient navigators are a natural solution.

In fact, in unveiling recent ACO ventures, insurers like Aetna and Cigna have highlighted nurse care coordinators as pivotal to the success of their ACO models, according to a recent article appearing in ACO Business News.

Why might they be the right fit for your practice? One reason is they are usually a more cost-efficient option than hiring non-physician providers. A recent job posting for a registered nurse care coordinator at Ohio State University Medical Center for instance, lists the maximum salary at $44,000.

And though these individuals may be less expensive for your practice to employ, that doesn’t mean they won’t be able to handle the responsibilities of the job.

Nurse care coordinators are often highly trained in care coordination, communication, and collaboration. For instance, a number of colleges offer courses and extended education courses covering such subjects.

The role of a patient navigator or nurse navigator may differ slightly from that of care coordinator.

Navigators are a good option for chronic care settings or larger integrated health networks, for instance, because they help patients “navigate” the healthcare system.

For instance, at Presbyterian Healthcare Services in Albuquerque, N.M, nurse navigators make appointments for patients, explain their treatment options and their medical conditions, and provide advice and support to patients, according to a recent article in the Wall Street Journal.

While usually navigators are registered nurses, other individuals, such as social workers, are sometimes employed in this role. A Colorado program, for instance, offers social workers, nurses, and community health workers training in patient navigating.

If your practice is planning to participate in a new model of care but does not have the means to hire care coordinators or patient navigators, there is a lower-cost option to consider.

In a recent Physicians Practice article, Richard Lopez, internist and chief medical officer at Atrius Health, suggested practices participating in ACOs consider hiring individuals with non-healthcare related degrees. These low-cost individuals can telephone and reach out to patients about follow-up care.