Partnering to Help Survivors Address Financial Hardships

Cancer care has come a long way in recent years, with breakthroughs and advancements in areas such surgery, radiology, symptom management, chemotherapy and immunotherapy. However, in many cases, these advancements have also increased the cost and complexity of care. For example, patients are now paying higher insurance premiums, deductibles, coinsurance and co-payments. The rise in care costs has created a new side effect for cancer patients– financial toxicity(1). This term refers to the negative impact the cost of cancer care can have on the patient’s financial circumstances such as their ability to pay for medical bills and everyday essentials like food and housing.

Fortunately, many different forms of assistance are available to help patients navigate the often financially challenging waters of cancer care. The Patient Advocate Foundation and LIVESTRONG have partnered to create a comprehensive suite of services for cancer patients to help them deal with medical debt and its side effects. By calling 1-855-220-7777 or by visiting www.livestrong.org/wecanhelp, a patient or their loved one can be connected with a navigator who can provide one-on-one assistance with a variety of problems such as difficulty paying for transportation, prescriptions, hospital bills, rent and utilities. Not only are both organizations dedicated to helping patients with their daily financial challenges, they’re also gathering data about financial toxicity to help shed light on its causes and consequences. The patients being assisted by this program and, thus, reflected in the data being gathered, are primarily low-income individuals who typically have either commercial insurance or Medicare. A little more than half are Caucasian with the remainder comprised of various racial and ethnic groups.

The self-reported prevalence of financial hardship in the patient population we assist is very high, at more than 90%. The acuity of that hardship is also high, with more than 80% describing their financial hardships related to their medical costs as severe to extremely severe. The sources of their financial distress are varied but several types of costs are identified as the most common sources of financial hardship: doctor appointments, prescriptions, hospital bills, surgery, radiology and laboratory costs. These costs tend to vary depending upon where in the continuum of care the patient is and when in the year the costs were incurred (ex. pre- or post-deductible costs).

The data suggest that the financial burden does have some impact on the patient’s medical care. For example, about a quarter of patients reported that they stopped treatment or following medical instructions. However, the majority of the impact appears to be concentrated on the everyday costs of living such as groceries, utility bills, rent, and car payments. Here’s a story illustrating this reality: When Jennifer’s two-year-old son was diagnosed with leukemia, they traveled from Idaho to Washington for weekly infusions. She soon lost her job because she spent all of her time taking care of her son and, as a result, could not afford rent or utilities or transportation costs to Washington. Jennifer called LIVESTRONG Navigation and her personal navigator worked to immediately obtain a charitable contribution to pay for her utilities, have her rent reduced to $4 a month and locate other charitable grants to cover transportation costs.

We encourage all stakeholders in the healthcare system to work together to reduce costs and improve outcomes, by providing high quality care that is both personalized and cost effective. We are supportive of recent efforts to shift away from the emphasis on volume of care to quality and value of care. For this transition to be effective, we must not only deliver better care but also reduce the financial burden on cancer patients. People buy health insurance to be free from the burden of financial distress and liability at their time of greatest medical need. However, the ever-growing cost of health care and the shifting of that cost burden to patients is leaving too many patients underinsured and overexposed financially.

Alan Balch, PhD
Chief Executive Officer
Patient Advocate Foundation

(1) Financial Toxicity, Part I: A New Name for a Growing Problem February 15, 2013 | Practice and Policy,