Essential insights on patient navigation implementation in oncology.

401 Background: As cancer care becomes increasingly complex, navigation services play a pivotal role in addressing gaps in care, improving adherence to care plans, facilitating coordination across multidisciplinary teams, and improving the overall patient experience. Despite their demonstrated value, navigation programs face inconsistent implementation and sustainability across practice settings, with ongoing reimbursement challenges posing significant barriers to their broader scalability. Methods: The Association of Cancer Care Centers (ACCC) in partnership with the Academy of Oncology Nurse & Patient Navigators (AONN+) assembled a working group of experts to guide the development of a survey. The survey was distributed to ACCC members in January 2025 to gather insights on the benefits and challenges of implementing navigation services in oncology clinical practice. Results: Survey respondents (n = 105) included physicians, administrators, supervisors, oncology nurse navigators, oncology social workers, oncology patient navigators, and financial navigators from 9 U.S. regions, reflecting 50 urban, 37 suburban, and 18 rural centers. Nearly all respondents reported that patient navigation services are very or extremely important in improving access to care (97%), addressing patient health-related social needs (100%), and increasing patient trust (94%) (Table 1). While Principal Illness Navigation (PIN) codes offer a pathway to support navigation reimbursement, adoption is low with only 7% of practices currently billing patient navigation codes. 26% have no plans to use PIN codes at all. Medicare requires the patient to pay a 20% coinsurance amount for patient navigation services. 96.4% of respondents indicated this is a barrier to access navigation services and 76.4% reported their organization is not currently helping the patient offset the cost share. Other barriers include site of care, funding, staffing, and role clarity. Conclusions: Patient navigation is crucial to quality cancer care, yet implementation remains inconsistent in part due to reimbursement gaps and cost-sharing concerns that shift the financial burden to the patient. To expand navigation equitably, efforts should focus on payment models that eliminate patient financial barriers and sustainably support the workforce. Future research should assess real-world implementation of PIN codes, cost-sharing mitigations, and outcome metrics to guide policy and practice. Survey question: From your perspective, how impactful is each benefit of patient navigation services to patients with cancer? Outcome Extremely important Very important Somewhat important Not very important Not at all important Improved access to care 77% 20% 3% 0% 0% Better management of treatment side effects 41% 38% 18% 3% 0% Increased patient trust 66% 28% 4% 1% 0% Better adherence to treatment plans 54% 34% 12% 1% 0% Addressing patient health–related social needs 74% 26% 0% 0% 0%