Author:
Jennifer Maggiore
Executive Director, NAPT
In the realm of cancer treatment, timely access to the most appropriate care is crucial to ensuring improved patient outcomes. However, for many cancer patients, particularly those requiring advanced treatments like proton therapy, accessing the right care can be an uphill battle. With only 45 operating proton therapy centers nationwide, and the majority of the population living more than an hour’s drive away from these facilities, the barriers to accessing this life-saving treatment are significant. This is where patient navigation programs come into play, offering a critical support system to help patients and their families overcome these obstacles.
As the Executive Director of the National Association for Proton Therapy (NAPT) and a licensed clinical social worker with many years as an oncology social worker, I have witnessed firsthand the challenges patients face in accessing advanced cancer treatments. Navigating the healthcare system is daunting, especially when dealing with a cancer diagnosis. Patient navigation programs are essential tools that can reduce barriers, thus reducing disparities in access to care by offering comprehensive support to cancer patients and their families.
Addressing the Access Gap
Proton therapy is a highly advanced form of radiation treatment that offers significant benefits over traditional radiation, particularly for tumors located near vital organs. However, despite its advantages, proton therapy remains relatively inaccessible for many patients due to the limited number of centers and the geographic distances involved. This scarcity creates a considerable access gap, disproportionately affecting patients in regions without proton therapy centers. As a result, these patients often face the challenge of securing lodging and traveling long distances for daily treatments. Managing cancer care away from one’s support system, along with the financial burden of lodging and lost income, adds to the difficulty
Patient navigation programs are designed to bridge this gap. These programs provide personalized assistance to patients, guiding them through the complex healthcare landscape. Navigators can help with everything from scheduling appointments to coordinating travel and lodging, ensuring that patients receive the care they need without unnecessary delays or disruptions.
For patients seeking proton therapy, navigators are especially crucial. They can help patients understand their treatment options, connect them with financial resources to cover travel expenses, and provide emotional support throughout the treatment journey. They can also guide the ever complex process of insurance denials which are disproportionally higher for advanced cancer treatments. By reducing the logistical and emotional burdens associated with accessing proton therapy, patient navigation programs play a pivotal role in ensuring that more patients can benefit from this cutting-edge treatment.
Reducing Disparities in Cancer Care
One of the most significant advantages of patient navigation programs is their ability to reduce disparities in cancer care. Disparities in access to treatment are a well-documented issue in the United States, with factors such as race, socioeconomic status, and geographic location contributing to unequal outcomes. A systematic review of 59 studies found that 70% of cancer patients enrolled in patient navigation programs experienced significant improvements in starting treatment, highlighting the critical role navigators play in ensuring timely access to care. [1]
Patient navigation programs work to level the playing field by providing support to those who need it most. Navigators, who are often licensed clinical social workers or experienced oncology nurses, help patients from underserved communities access resources they might not otherwise be aware of, such as charity programs that cover the cost of travel or temporary housing near treatment centers. They can also connect patients with local support groups and counseling services, helping to alleviate the emotional stress of managing cancer treatment.
The importance of these services has been recognized at the highest levels of government. The Cancer Moonshot initiative, launched by President Biden, has prioritized the expansion of patient navigation programs as a key strategy for improving cancer care in the United States. This commitment underscores the critical role that navigation programs play in ensuring that all patients, regardless of their circumstances, have access to the best possible care.
Supporting Providers Through CMS Reimbursement
The Centers for Medicare & Medicaid Services (CMS) has also taken steps to support the expansion of patient navigation programs. In its final rule on the 2024 Medicare Physician Fee Schedule (MPFS), CMS included reimbursement for patient navigation services, recognizing the value these programs bring to both patients and providers. This reimbursement policy is a game-changer for healthcare providers who want to establish or expand navigation programs but may have been deterred by the associated costs.
This support is particularly important for smaller, community-based providers who may not have the resources to fund navigation programs on their own.
Leading the Way in Education and Credentialing
The American Cancer Society (ACS) has been at the forefront of efforts to educate and credential patient navigators. Through its comprehensive training programs, ACS is helping to ensure that navigators have the skills and knowledge needed to effectively support cancer patients. These programs cover a wide range of topics, from understanding the clinical aspects of cancer treatment to providing culturally competent care and addressing the unique needs of diverse patient populations.
At NAPT, we have partnered with ACS to educate our members on how to establish patient navigation programs within their own proton therapy centers. In a recent webinar hosted by NAPT, ACS provided valuable insights into the best practices for implementing these programs and shared success stories from centers that have already made navigation services a core part of their patient care strategy.
Many of the NAPT member centers have been offering patient navigation services for years, driven by a commitment to ensuring that every patient who could benefit from proton therapy has the support they need to access treatment. These centers recognize that providing navigation services is not just about helping individual patients; it’s about creating a more equitable healthcare system where advanced treatments like proton therapy are accessible to all who need them.
In the fight against cancer, access to the right treatment at the right time is critical. For patients needing proton therapy, patient navigation programs offer a lifeline, helping them overcome the numerous barriers to accessing this advanced treatment. By providing personalized support, reducing disparities, and ensuring that no patient is left behind, navigation programs are transforming cancer care for the better.
[1] Chen M, Wu VS, Falk D, Cheatham C, Cullen J, Hoehn R. Patient Navigation in Cancer Treatment: A Systematic Review. Curr Oncol Rep. 2024 May;26(5):504-537. doi: 10.1007/s11912-024-01514-9. Epub 2024 Apr 6. PMID: 38581470; PMCID: PMC11063100.
