A Primer on Linkage and Patient Navigation

Shared from CBA Intern Yonas Asif

There is a significant difference between HIV Navigation, Patient Navigation and Linkage to Care. It is important to know the difference between the three because they all play a different role in addressing the HIV virus. Some people tend to get these terms mixed due to various reasons. HIV Navigation is the not the same as Patient Navigation although it is a form of it. Someone who is an HIV Navigator might not also be a Patient Navigator because HIV Navigators focus specifically to issues to HIV.

HIV Navigation

HIV Navigation is a set of services designed to guide a patient or client who is infected with HIV through the complexities of accessing healthcare and social services and facilitate adherence to prevention and care plans. Clients tend to be paired with those who are of similar background or have overcome similar obstacles to help them meet their needs. HIV Navigation was started as a result of the Affordable Care Act (ACA). The ACA was designed to ensure that everyone received access to health care. People living with HIV/AIDS need to receive some form of treatment plan to help virally suppress their infection and that is where HIV Navigators come in. They help those who are infected find coverage for their care. Navigators are providers who are often trained in counseling, outreach, case management, HIV treatment education and/or specific models of behavior change such as motivational interviewing. They help those who are HIV positive to finance their medical costs.

HIV Continuum of Care is a model that is used by government agencies to address the issues related to the delivery of quality health care to those living with HIV. There are five main stages to HIV continuum: HIV diagnosis, getting linked to care, staying in care, getting antiretroviral therapy and virally suppressing the HIV virus. It shows a proportion on how those with HIV are progressing in the stages of their care. For example, according to the U.S. Department of Health and Human Services, 82% of the 1.1 million Americans living with HIV have been diagnosed while only 25% have had the infection virally suppressed.

Patient Navigation

Patient Navigation for the Affordable Care Act (ACA) sets out to ensure that patients have access to quality and affordable health care. Due to lack of insurance or high out of pocket expenses, many patients have not received the quality of medical treatment that is needed to address their health issues. That leads to an increase in mortality rates among those of low socioeconomic status. Navigators play a vital role in the health insurance marketplace and help bridging the gap between minorities and quality health care. They help patients understand what their insurance options are. They also act as a liaison between clients and health care providers and help develop clients’ skills so that they are able to interact with providers. Responsibilities outlined for patient navigators in the ACA include (1) providing expertise on eligibility, enrollment and cover details on each plan, (2) providing information in a fair, accurate and impartial manner, (3) facilitate the enrollment process and (4) provide referrals for conflict resolution services for enrollees with complaints or concerns.

Linkage to Care

Linkage to Care was set up to make sure that those who diagnosed with HIV are connected to health care as soon as possible so that their infection can be virally suppressed. Not only is it vital to link people to care, but to also ensure that they remain in and keep up with their treatment. Many patients tend to drop out of care so linkage to care reaches out to those people and help them connect with their treatment. According to the U.S. Department of Health and Human Services, 66% of people infected are linked to care and only 37% are retained with their care. The sooner patients that are linked to care, the less likely they are to transmit the infection to others and the less likely the HIV would lead to AIDS. Navigators are the ones who help patients get linked with health care treatment. They represent the link that connects and addresses the disparity between those who lack access to quality health care and the available treatment. The ACA was passed by Congress to ensure that everyone in the U.S. have access to affordable and quality health care. By making health care affordable and available to everyone, it makes it easier for navigators to connect newly diagnosed patients or reconnect those who had previously withdrew from care to the proper treatment that they need.

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