CMS's Decision to Pay Doctors for Patient Navigation Services
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Fierce Healthcare
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Every day, doctors, nurses and administrative staff work under the adage, "Where there’s a will, there’s a way.”
They’re paid to provide clinical care to patients in need, but sometimes those patients also struggle with personal challenges or circumstances beyond the medical issues that get in the way of that care. At such moments, extra support can make all the difference in the world.
So, while it may not sound glamorous, the Center for Medicare and Medicaid Services’ (CMS) decision to reimburse Principal Illness Navigation services has the potential to be transformational and to significantly impact the quality of care that high-need patients with long-term illnesses like cancer or diabetes receive. “PIN”, as it is known, will reward providers for the extra support that many are already giving patients at a cost to their own bottom line. These new reimbursement codes are a major step forward toward recognizing patient navigation as a critical component of healthcare. Real effort, money and legislation has finally been put behind these services, and we applaud CMS’ efforts.
PIN is not a cure-all, however. Its true impact will need to be assessed in the context of how far it goes to meet CMS’ larger goals around value-based care.
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