Association of a Lay Health Worker Intervention With Symptom Burden, Survival, Health Care Use, and Total Costs Among Medicare Enrollees With Cancer

Question  Is a lay health worker–led screening and referral intervention associated with patient symptom burden, acute care use, and total costs of care?

Findings  In this multisite quality improvement study of 425 Medicare Advantage enrollees with a diagnosis of cancer who were provided usual cancer care augmented by a lay health worker trained to proactively screen patient symptoms, discuss symptoms with a physician assistant, and refer patients with uncontrolled symptoms to palliative care and behavioral medicine compared with 407 control patients diagnosed and treated in the year prior, patients in the intervention group were associated with significant reductions in symptom burden over time, and patients in the control group were associated with worsening symptoms over time. Patients who received the intervention were associated with fewer inpatient and emergency department visits and lower median total costs, and there were no differences in survival.

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