Care Navigation in the Management of Urinary Stone Disease: An Opportunity to Improve Care Access While Reducing...

There is a care gap in the treatment course of kidney stone disease that contributes to access delays and exacerbates adverse and costly outcomes. Populations that fail to access care are especially at risk when it comes to urinary stone disease (USD). Nearly 40% of individuals with kidney stones presenting for care to the emergency department (ED) do not receive any physician follow-up and almost 80% never see a urologist. For those individuals who pass their kidney stones, lack of appropriate follow-up increases the risk of stone recurrence. For those who do not pass their stones, delayed treatment increases risk for complex surgical treatment making care cost higher in the long term. In January 2024, Centers for Medicare and Medicaid Services (CMS) approved billing codes allowing for reimbursement for care navigator services which presents an opportunity to improve follow-up for at-risk individuals. Support from a navigator may both reduce morbidity from stone disease and lower overall care costs.