EXPRESS: Impact of Patient Navigation Programs on Emergency Department Utilization

Patient navigation (PN) programs have been widely implemented to improve healthcare access and reduce avoidable healthcare utilization through care coordination and preventive care management. However, evidence regarding their effectiveness and economic impact remains limited. In this study, we examine the impact of patient enrollment in a PN program in a large Accountable Care Organization (ACO), on emergency department (ED) utilization. Using longitudinal, patient-level data and a staggered difference-in-differences design combined with sliding-window, propensity score matching, we find that PN enrollment significantly reduces ED visit utilization. This effect, however, diminishes over time, indicating decreasing marginal returns to prolonged PN engagement. We also identify substantial heterogeneity in treatment effects across patients’ unique clinical characteristics. To better understand these patterns, we complement our empirical analysis with qualitative insights from healthcare practitioners, highlighting mechanisms related to patient engagement, care coordination, and resource allocation. We further estimate the economic implications of PN adoption. While reductions in ED utilization generate measurable cost savings, these savings alone do not fully offset per-patient program costs, suggesting that the full value of PN programs extends beyond reductions in ED utilization to other aspects of patient care and care coordination. Overall, our research contributes to the operations management literature by revealing the dynamic effectiveness of care coordination interventions over time and across patient populations, while offering practical insights for designing more targeted and cost-effective PN programs. To our knowledge, this is among the first studies to examine the operational value of PN programs within a value-based care reimbursement setting.