ideasIdea
A paid patient navigator for every new cancer diagnosis, reimbursed as a service
Every newly diagnosed patient gets a named person whose job is to get them through appointments, tests, paperwork and money problems. Insurers should pay for it because it prevents delays and dropouts.
Patient navigation programmes improve time to treatment and completion, particularly for disadvantaged groups, and randomised evidence exists. In the US, Medicare began paying for principal illness navigation services in 2024, creating a reimbursement route. Elsewhere navigation depends on charity funding. The proposal is to make navigation a reimbursed service from diagnosis to end of treatment, with standard training, caseloads, and outcome reporting.
Hypothesis
Universal funded navigation will reduce time from diagnosis to first treatment by at least 20% and reduce the gap in treatment completion between the most and least deprived quintiles by half.
Rationale
Navigation addresses the practical barriers (transport, scheduling, understanding, cost) that cause delays; it works best when it is a paid role rather than a volunteer one.
What would test it
A payer-level pilot in two regions with time to treatment, completion, emergency visits, and cost offsets as endpoints against matched non-pilot regions.
Maturity
being tested at scale
Who has to act
payer
Cost to try
Medium ($1M to $50M)
Years to first evidence
3
Bottlenecks it attacks
- Fragmented care and guideline gaps · Patients fall between specialists, wait for referrals and often do not get the treatment guidelines say they should.
- Patients lack understanding, navigation and agency · Most patients cannot understand their options, find trials, or push back, so decisions are made for them.
- Trials do not represent the people who get cancer · Older, Black, Hispanic, Asian, rural, poor and multimorbid patients are under-represented, so results may not apply to them.