Financial Navigation Improves Financial Toxicity for Patients and Oncology Care Model Compliance for Cancer Centers

Creating the role of a financial navigator (FN) was instrumental in reducing out-of-pocket costs for patients with cancer and improving patient distress related to financial concerns, according to a presentation at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting, held in Chicago.

The cost of cancer treatment can be a significant financial burden for patients, even those who are well-insured. Higher deductibles, increasing premiums, and frequent copayments contribute to patients’ risk for financial toxicity. A team at the Cleveland Clinic Cancer Centers in Cleveland, Ohio, sought to find a way to identify patients at risk for financial toxicity and help to mitigate its effects.

“In 2015, we initiated huddles for all new patients to ensure 7-day access for our patients, as well as out-of-network authorization,” explained the researchers. The cancer center is a participant in the Oncology Care Model (OCM), which requires that patients’ estimated out-of-pocket expenses be documented in their medical records. These efforts highlighted the need for a care team member who would be dedicated to exploring cost-reducing options for patients.

The FN was charged with completing an investigation of benefits to determine covered services. The navigator then called patients undergoing treatment to review their benefits with them, help them apply for copay assistance and free drug options, and connect them with resources for assistance when copay assistance isn’t an option.

Since the role was created in 2016, the team of financial navigators has grown to 7 full time employees. Notable achievements made on behalf of patients include a 70% increase in the dollar amount approved through copay assistance applications, and a 55% increase in free drug value. Data show that money collected from copay assistance programs for patients’ out-of-pocket costs more than doubled in 2018 compared with 2017.

In addition, the facility was able to comply with the out-of-pocket expense metric for OCM for all treatment patients, not just its Medicare patients. Compliance increased from 44% in December 2018 to 98% in April 2018, and continued at a goal of 96% or higher throughout 2018.

Furthermore, relationships with social workers, care coordinators, and community services have enabled the FNs to also help patients with nonmedical financial stressors, including household utilities, childcare concerns, food, and mortgages.

Reference

Monak M, Bell K, Whitt A. Development of a financial navigation program to ease the burden of financial toxicity. Poster presented at: 2019 ASCO Annual Meeting; May 31 to June 4, 2019; Chicago, IL. Abstract 6565.