“We’ve seen over and over from an access standpoint how that makes a difference, then especially when you’re looking across racial disparities, ethnic disparities, geographic disparities, that having that person who can break down those barriers then is a great equalizer in that process,” Bonny Morris, PhD, MSPH, RN, senior director of navigation at the American Cancer Society, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about addressing disparities in cancer care through patient navigation and new rules from the Centers for Medicare and Medicaid Services (CMS) on principal illness navigation.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod 

Licensed under Creative Commons by Attribution 3.0 

The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to the role of the oncology navigator.

Episode Notes

• The NCPD activity for this episode has expired, but you can still earn NCPD through many other ONS Podcast episodes. Find a full list of opportunities.
• Oncology Nursing Podcast episodes:
  • Episode 64: Oncology Nurse Navigators
  • Episode 158: Navigate Patients Through Metastatic Colorectal Cancer Treatment and Survivorship
  • Episode 229: How Advocacy Can Shape Your Nursing Career
• ONS courses: Equipping the Novice Oncology Nurse Navigator: An ONS Collaboration with AONN+
• ONS books:
  • Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum (second edition)
  • Telephone Triage for Oncology Nurses (third edition)
• ONS Voice articles:
  • Oncology Navigation Standards Help Patients Overcome Disparities and Barriers to Care
  • Task Force Recommends Patient Navigation Services Increase Certain Cancer Screening to Advance Health Equity
  • Oncology Nurse Navigator Roles Are Transforming Cancer Outcomes for Underserved Rural Patients
  • New Roles in Oncology Nurse Navigation
• Clinical Journal of Oncology Nursing articles:
  • Lean Practices for Resource Use, Timeliness, and Coordination of Care in Breast Cancer Navigation
  • Low-Dose Computed Tomography: Effects of Oncology Nurse Navigation on Lung Cancer Screening
  • Oncology Nurse Navigation: Expansion of the Navigator Role Through Telehealth
• Oncology Nursing Forum article: Oncology Nurse Navigator Effect on Emergency Department Visits and Hospital Admissions of Adults With Cancer Post–Outpatient Chemotherapy
• ONS Huddle Cards
• ONS Nurse Navigation Learning Library
• ONS 2017 Oncology Nurse Navigator Core Competencies
• Oncology Navigation Standards of Professional Practice
• Oncology Nursing Certification Corporation CBCN® Role Delineation Study: Executive Summary
• American Cancer Society resources:
  • ACS CARES™ (Community Access to Resources, Education, and Support)
  • Building Expertise, Advocacy, and Capacity for Oncology Navigation (BEACON) Initiative
  • Cancer Action Network
  • Health Equity Ambassador Program
  • Leadership in Oncology Navigation (LION)
  • National Navigation Roundtable
  • What Can a Cancer Navigator Do for Me? (patient resource)
• CMS: Health Equity Services in the 2024 Physician Fee Schedule Final Rule

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

“When you get hit with that diagnosis, it’s like time stops. And even if the person that’s delivering that news—they’re trying to provide the best communication possible—but you just don’t hear anything else. And you’re overwhelmed trying to process everything and trying to just figure out, what is that next step?” TS 8:52

“There’s the person providing the navigation services, and then there’s the billing practitioner who then is submitting the codes that allow for the reimbursement. . . . So you have the person providing navigation services who may be an oncology nurse. It may be a health worker. It may be a patient navigator. It could be an ambulatory nurse. So it’s dependent upon these services being provided and not the title, and CMS is clear about that. And it describes within the final rule the different activities that can be applied and how they relate to then competencies that the person providing navigation services should either be trained or certified in.” TS 16:53

[American Cancer Society has] a training program to support. We have implementation programs that we’re supporting that we’ve built out. And so it’s really trying to be responsive to the needs of those who are boots on the ground implementing these codes. And how can we make it easier? Because we know that patients deserve this. So if we’re able to now have this more sustainable pathway, let’s make it easier to get to that point.” TS 20:10

“So for the patient consent process, it can be done verbally, as long as it’s documented that it took place, because there is that 20% cost sharing that the patient could receive a bill for if they don’t have additional coverage for that. And I worry that that could increase disparities, truthfully, because it’s going to be the subset of the population that then needs it the most, that then could say no because of the concern over that additional copay. I think that is something that we need to watch very carefully and continue to advocate for alternatives around and how we can support patients in continuing to have equitable access regardless of the ability to pay for that portion of navigation. Because we’ve never done that. We’ve never charged patients for navigation until now.” TS 21:22

One of the things that [American Cancer Society] is committed to is continuing to keep our training relevant, updated year after year, with having annual refreshers, having curriculum that is responsive—we know that oncology landscape is ever-changing, right? So how do we stay abreast of that as professionals? And working with ONS to make sure that we’re keeping all of those hot topics infused within that curriculum in a way that is practical and meaningful for the professional. They need to digest that information and then run with it. ONS is a fabulous partner with that.” TS 39:02