4 Keys to Patient Navigation

This video provides an in-depth exploration of the "Four Keys to Patient Navigation," drawing on the extensive experience of Dr. Eric Bricker, a co-founder of Compass Professional Health Services. Dr. Bricker recounts the genesis and growth of Compass, one of the original patient navigation companies, which grew to serve 1.8 million members across 2,000 employer clients over 11 years before being acquired by Alight Solutions. The video's main purpose is to share critical insights gleaned from this large-scale operation about how patients interact with and navigate the complex US healthcare system.

The presentation details two initial key insights. Firstly, patient navigation has evolved from a nascent concept into a widespread and valuable service, now integrated into various healthcare entities such as Accountable Care Organizations (ACOs), on-site clinics, Medicare Advantage plans, oncology departments, employer-sponsored plans, and Medicaid programs. Specific examples include Methodist Health System's ACO, Proactive MD's on-site clinics, Devoted Health for Medicare Advantage, and Memorial Hermann Health System's dedicated oncology navigators. Secondly, Dr. Bricker emphasizes that their work provided a "tremendous cross-sectional view" of patient behavior across all 50 states and numerous medical specialties. This perspective revealed significant geographic variations in how patients access care; for instance, patients in the Northeast (Washington D.C. to Maine) tend to bypass primary care physicians (PCPs) and directly access specialists due to a high concentration of specialists, a trend not observed in the Midwest, South, or West. Furthermore, the most common doctor searches through navigators are for PCPs (outside the Northeast), followed by OBGYNs and orthopedists, with all other specialties tying for third.

The third key insight focuses on the patient's primary motivators when seeking a doctor: "time" and "location." Patients overwhelmingly prioritize getting an appointment quickly (ideally within seven days) and having the service location be close, familiar, and easy to access. Surprisingly, factors like price or quality are secondary to these immediate concerns. Dr. Bricker explains that fear of the unknown (xenophobia) and an aversion to difficulty significantly influence patient behavior, making ease of access and familiarity crucial. If a location is perceived as too hard to get to, two-thirds of patients will simply not go. This highlights that basic access and convenience are fundamental challenges that patient navigation must address before more complex considerations.

Finally, the fourth key insight underscores the highly female-driven nature of household healthcare decisions. Women are responsible for over 80% of medical decisions for themselves, their children, and their partners. This demographic reality necessitates a specific communication approach for patient navigators. Dr. Bricker notes that women typically communicate to establish relationships, contrasting with a more transactional male communication style. Therefore, effective patient navigation communication must be relationship-driven, ideally involving the same navigator over time to build trust and rapport. While modern communication channels like phone, email, text, or in-person interactions can be utilized, the emphasis remains on fostering a strong, consistent human connection. These collective insights offer a foundational understanding of patient needs and behaviors within the healthcare ecosystem.

Key Takeaways:

• Patient Navigation is Ubiquitous and Valuable: Patient navigation has become a mainstream and essential service, widely adopted by diverse healthcare entities including ACOs, on-site clinics, Medicare Advantage plans, oncology departments, employer-sponsored plans, and Medicaid programs.
• Cross-Sectional View Reveals Geographic Disparities: Extensive patient navigation services provide a unique, broad perspective on healthcare utilization, highlighting significant geographic differences in patient behavior, such as the direct access to specialists in the Northeast versus the greater reliance on PCPs in other regions.
• Prioritization of Physician Types: Outside the Northeast, the most common physician type patients seek help finding is a Primary Care Physician (PCP), followed by OBGYNs and Orthopedists, indicating where navigation efforts can be most impactful.
• "Time" and "Location" are Paramount for Patients: When searching for a doctor, patients prioritize the speed of getting an appointment (ideally within 7 days) and the proximity, familiarity, and ease of access to the service location above other factors like price or perceived quality.
• Access is a Core Challenge: The fundamental value of patient navigation often lies in simply helping patients overcome the difficulty of scheduling appointments and finding convenient locations, addressing the "access" barrier before more complex care coordination.
• Fear and Difficulty Deter Care Seeking: Patient decisions are heavily influenced by fear of the unknown and an aversion to difficulty; making healthcare access easy and familiar is crucial, as two-thirds of people will avoid care if it's perceived as too hard.
• Women Drive Household Healthcare Decisions: Over 80% of healthcare decisions within a household are made by women, making them the primary target for patient navigation communication and requiring a tailored approach.
• Relationship-Driven Communication is Essential: Effective patient navigation communication, especially with women, must focus on establishing and nurturing relationships rather than being purely transactional, emphasizing trust and continuity with the same navigator.
• Modern Communication Channels Support Connection: While the human connection is paramount, patient navigators can leverage various modern communication methods (phone, email, text, in-person) to maintain consistent, relationship-driven interactions.
• Insights Inform Commercial and Patient Support Strategies: Understanding patient priorities (time, location), decision-makers (women), and access challenges can profoundly inform pharmaceutical and life sciences companies in developing more effective commercial strategies, patient support programs, and digital solutions.

Key Concepts:

• Patient Navigation: A service designed to guide patients through the complex healthcare system, helping them find providers, schedule appointments, understand their benefits, and overcome barriers to care.
• Cross-Sectional View: A broad, aggregated perspective of patient data and behavior across diverse demographics, geographies, and medical specialties, providing comprehensive insights into healthcare utilization patterns.
• Access (Healthcare): Refers to the ease with which individuals can obtain needed healthcare services, encompassing factors like appointment availability, geographic proximity, transportation, and ease of navigation through administrative processes.
• Relationship-Driven Communication: A communication style focused on building rapport, trust, and a sustained connection with an individual, particularly important in sensitive areas like healthcare navigation.

Examples/Case Studies:

• Compass Professional Health Services / Alight Solutions: Dr. Bricker's former company, which provided patient navigation services to 1.8 million members across 2,000 employer clients, demonstrating the scale and impact of such services.
• Geographic Variation in PCP Use: The example of the Northeast (Washington D.C. to Maine) having a high concentration of specialists leading to patients directly accessing specialists, contrasting with other regions where PCPs are more commonly sought.
• Oncology Patient Navigators: Memorial Hermann Health System in Houston employs 20 dedicated oncology patient navigators to help patients navigate the complexities of cancer treatment.
• Companies Utilizing Navigation: Methodist Health System ACO (Dallas, TX), Proactive MD (on-site clinics), Devoted Health (Medicare Advantage), and City Block Health (Medicaid) are cited as examples of organizations integrating patient navigation into their models.