Barriers to Care
Patient navigation and case management are supportive care resources designed to help manage the practical issues related to a serious illness such as cancer. These issues may include health insurance, financial concerns, employment regulations, transportation and care coordination. These are often referred to as “barriers to care” because they can stand in the way of people receiving the best care available.
How Can a Navigator or Case Manager Help?
You are understandably focused on treating your cancer, so it helps to have someone address and resolve these barriers to care. As your personal advocate, your navigator or case manager will draw on their professional experiences as they collaborate with health care professionals and non-medical personnel to find solutions to very specific short-term needs or long-term issues. This can begin right after diagnosis and continue throughout treatment.
Navigation and case management are typically free services within your hospital or treatment center, but not all organizations have them. However, they usually have someone who takes on that role, such as a social worker, financial counselor, nurse or some combination of these areas of expertise. If you aren’t provided this service automatically, it is perfectly appropriate to ask about it so you can learn more about these important areas.
Health insurance claims. Your navigator or case manager can help you carefully review your insurance policy so you know the rules and procedures to follow and the treatments that are covered, including the items covered by Medicare Parts A, B, C and D. This is crucial in regard to treatment options, and you are encouraged not to make these important decisions until you have looked into the financial resources that are available. This applies to you even if you are uninsured or underinsured.
The paperwork that comes with a cancer diagnosis can pile up quickly. Your navigator or case manager can assist with organizing and filing documents. Their expertise is especially helpful if you have a claim that has been denied because there are certain ways to respond to insurance companies. Let them reduce your insurance-related anxiety and guide you through these issues.
Financial concerns. Worrying about being able to afford food, rent and utilities in the face of a reduced or stalled income is common. It makes an already stressful situation even more challenging and can affect your emotional and physical health. You may even hesitate to report side effects to your health care provider because you think you can’t afford additional medication. Never let your financial woes keep you from getting the medical attention you need. Reach out to your navigator or case manager. It is nothing to be embarrassed or ashamed of. Cancer care is expensive.
Employment regulations. Your employer is obligated by law to provide reasonable accommodations for you. To learn more about how employees affected by cancer are protected legally in the workplace, talk with your supervisor and a member of your Human Resources department. It is essential to understand the laws and benefits surrounding your employment, such as the Americans with Disabilities Act (ADA) and the Family and Medical Leave Act (FMLA). Ask your navigator or case manager if you have questions or concerns. If they cannot help you, they will connect you with someone who can.
Transportation. Reliable transportation is crucial because your appointments, treatment and follow-up care are designed to follow a specific schedule. Straying too far from that schedule could reduce the effectiveness of your cancer care.
You and your family members may need assistance getting to school, work, the grocery store or other places. If you don’t have a friend, family member or caregiver who can drive, your navigator or case manager can explore other options. Some advocacy organizations offer free transportation services to people undergoing cancer treatment.
Care coordination. You may have medical questions that do not require the attention of a health care professional. While your health care team focuses on your treatment and side effect management, your navigator or case manager can help you understand the various facets of your care. They can even offer assistance if you are nearing end of life. For example, they may be able to arrange for door-to-door transportation from the medical facility to home, and ensure a hospice company, necessary equipment and a nurse are on site before you arrive. The goal is to help you feel secure and comfortable, surrounded by people who care, in the last moments of life.
Patient education. These health care professionals can explain the treatments you will be having in an easy-to-understand way. They can personally offer psychosocial support and are well-networked within the community to link you to other resources.
Learn More
Ask about this resource soon after you receive your diagnosis. If your care team does not have someone in this role, request a referral. You deserve all the resources you can get.
Once you connect with a navigator or case manager, keep the lines of communication open. Share contact information with each other and decide on the best way to keep in touch, such as text messages, phone calls, emails or a health care portal/app. Introduce your caregiver or loved ones to broaden that circle of support. How you choose to use this valuable resource is based on your needs, but you can take comfort in simply knowing it is available.
