Navigation Services

Time to read: 2 minutes.

Navigators are professionals who coordinate care and services across siloed mental, behavioral, and physical health care delivery systems, leading to greater holistic and person-centered care. The combination of services coordinated by the navigator is fundamentally driven by an individual’s needs. Navigation services can help providers deliver more integrated care to people with chronic or complex medical conditions. Such services include linking individuals (and their natural supports) with essential health and community services.  One way in which navigation services differ from traditional care coordination services is that navigators often interact with people face-to-face and monitor receipt of services.

Individuals who are dually eligible for Medicare and Medicaid experience high rates of chronic illness, with many having long-term care needs and social risk factors. Forty-one percent of dually eligible individuals have at least one mental health diagnosis, 49% receive long-term care services and supports (LTSS), and 60% have multiple chronic conditions.1,2

  • Navigation services can help these individuals by recognizing the interconnectedness of mental and physical health.
  • Through offering navigation services, medical providers and behavioral health agencies can expand their capacity to deliver care that is more integrated and reduce gaps in care.

Resources for Integrated Care has developed many products to help organizations and providers serving dually eligible individuals better understand navigation services and how to implement these services in their organizations

1 Physical and Mental Health Condition Prevalence and Comorbidity among Fee-For-Service Medicare-Medicaid Enrollees. Centers for Medicare & Medicaid Services, September 2014. Available at: https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/Downloads/Dual_Condition_Prevalence_Comorbidity_2014.pdf.

2 Medicare-Medicaid Enrollee Information, National 2012. Available at: https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/Downloads/NationalProfile_2012.pdf.