The rise of oncology nurse navigators in the shift to value-based cancer care

This article was originally published here

A cancer diagnosis can be frightening and confusing for a patient. There’s where the nurse navigator comes in.

Navigators are often oncology nurses who offer individualized assistance to patients, their families, and their caregivers to overcome barriers in the healthcare system through the duration of the patient’s treatment. That might mean providing educational materials to a patient or working with a patient’s oncologists to help gain access to clinical trials. Sometimes a navigator’s tasks have nothing to do with a patient’s cancer diagnosis — like finding a babysitter. Helping patients manage their cancer care and plan for the future is quickly becoming as important as administering chemotherapy treatment for the roughly 1.68 million Americans diagnosed with cancer last year.

As of last summer, the job of a navigator became even more crucial, as Tricia Strusowski, a registered nurse and consultant with Georgia-based Oncology Solutions, explained during a talk at the Association of Community Cancer Center’s 43rd annual meeting in Washington, D.C., last week.


Many of the current cancer patients in the U.S. are 65 years or older and paying for treatment using Medicare benefits. In search of a new way to provide better quality and more coordinated oncology care, the Centers for Medicare and Medicaid Services (CMS) rolled out a new model for delivering care to cancer patients over the summer last year. The Oncology Care Model (OCM) is a five-year model being tested through June 2021 with nearly 200 physician groups and 17 payers. The goal: Better care, smarter spending, and, ultimately, healthier patients.

One of OCM’s hallmarks is that all the participating practices, as well as the CMS, have committed to providing enhanced services, like navigation, to cancer patients on Medicare. Already some early results from several participating practices are showing the difference. At one oncology practice in Pennsylvania, enhanced services including navigation have resulted in a 51 percent drop in emergency room visits among cancer patients.

But as the role of the navigator becomes more important, so too does the means by which navigators can measure job performance. As of this year, a new set of 35 navigation metrics is available to oncology practices participating in the OCM. The metrics are a baseline, which can be used by any medical institution, and were developed in part by Strusowski, — she was one of the team leaders of the Standardized Metrics Task Force of the Academy of Oncology Nurse and Patient Navigators.

As the Journal of Oncology Navigation & Survivorship noted in January, the metrics set guidelines on how navigators should communicate with patients and healthcare providers to help coordinate cancer care, “evaluate professional practice and care delivery and measure the impact of navigation.”

During her talk, Strusowski mentioned that the metrics will not only help demonstrate the value of navigation, but will also help meet the OCM program’s overall goal.

“The navigator needs to stay one step ahead of the patient,” she said. “And how can you enhance the patient experience when we don’t know what to measure on our navigation programs?”

Photo:, Getty Images

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