All patients with newly diagnosed cancer, over the age of 75 with a medical record number ending in an odd number up to 200 patients will be included in the CareMore Pilot 2 Program. Any patients who decline to participate will be excluded from the 200 patients in the CareMore Pilot 2 Program. The first 200 patients who do not qualify will be the control group.
Undertreated patient symptoms and resulting acute care use require approaches that improve symptom-burden. Previously a lay health worker (LHW)-led symptom screening intervention was developed for patients with cancer. In pilot work, the intervention was associated with improvements in patient symptom burden and reductions in healthcare use and costs of care at the end of life. This intervention will be expanded across several clinics to evaluate the impact of the LHW intervention on with cancer and the LHW will be trained to refer patients to palliative care. This randomized intervention will evaluate the effect on healthcare use, total costs, palliative care and hospice referral.