Over the past decade, the field of oncology has seen remarkable advances stemming from a better understanding of the molecular biology of many cancer types. This growing body of knowledge has led to improvements in detection, diagnosis, and cancer treatment, including targeted therapies and innovative cellular products.
Unfortunately, one significant side effect of cancer has remained intractable: the potential for financial toxicity. Despite ongoing discussion and debate among policymakers, legislators, patient advocates, payers, manufacturers, and providers, no immediate solution to the economic burden experienced by individuals in active treatment—and by post-treatment survivors—is on the horizon. In the last 10 years, multiple studies have reported on the financial fallout experienced by cancer patients and post-treatment survivors.1-3
Navigating a health care system that is in the throes of fluctuating reforms, shifting policies, and transition to new payment models is challenging for all stakeholders.
For patients with cancer and their families, information surrounding cancer diagnosis and treatment plans is lifechanging. At the same time, patients are challenged with understanding the costs of care, interpreting their health plan’s coverage to parse out what will be paid for and what will not, determining available assistance, and mitigating the costs of care. To meet these needs, a new team member has joined the staff at many cancer programs and practices: the financial navigator.
The Association of Community Cancer Centers (ACCC) created the Financial Advocacy Network to support all cancer program staff responsible for helping patients navigate the financial issues surrounding cancer care delivery. Launched in 2012, the ACCC Financial Advocacy Network continues to develop education, tools, and resources in response to the changing, real-world needs of all cancer program staff—including clerical, billing, administrative, pharmacy, nursing, social work, and other professionals who find themselves filling this critical, evolving role.
Long-time Financial Advocacy Network member Lori Schneider, Operations Manager at Green Bay Oncology in Wisconsin, helped create the first financial counselor role at her program. “It’s a key role,” said Ms Schneider, “and the need for it is expanding, especially with the current insurance structure and huge out-of-pocket expenses for patients.” This year, she is chairing the Advisory Committee for ACCC’s Financial Advocacy Network.
The ACCC Financial Advocacy Network online hub is full of resources, tools, education, and event information, including the below.
ACCC Financial Advocacy Services Guidelines—released in 2018, the guidelines support the goal of proactively addressing financial issues along the cancer care continuum to help patients gain access to high-quality care for a better quality of life.
Financial Advocacy Boot Camp—to date, Boot Camp Level I, foundational online training, has more than 1000 graduates. Financial Advocacy Boot Camp Level II, with more in-depth information and resources for financial advocates, is launching March 2020.
Learning Labs—single day, on-site workshops deliver support for cancer programs interested in exploring process improvement to advance financial advocacy services.
National Summit Meetings—these one-day events bring financial advocates, oncology leaders, patient advocates, and allied professionals together for facilitated discussion on resource needs, policy, and ongoing and emerging challenges.
Toolkit—curated resources to support financial advocates, including position descriptions, sample forms and letters, and checklists.
Town Hall Discussions—financial advocates and Advisory Committee members join in virtual own Hall meetings for conversation on current challenges, best practices, and lively Q&A.
Financial Advocacy Network Forum—this online community offers an opportunity for peer-to-peer networking, resources sharing, and problem-solving.
Although cancer programs and practices are not reimbursed for the services their financial advocates provide, Ms Schneider noted that these positions more than pay for themselves: “I want organizations to fully understand the benefits of having a financial advocate on staff, including improving patient satisfaction, decreasing patient anxiety about finances, and obtaining better reimbursement. All of these things are good for the patient and good for the bottom line. The more help we can provide patients, the more it’s a win-win for the organization and those we treat.”
References
1. Altice CK, Banegas MP, Tucker-Seeley RD, Yabroff KR. Financial hardships experienced by cancer survivors: a systematic review. J Natl Cancer Inst. 2016;109(2).doi:10.1093/jnci/djw205
2. Thom B, Benedict C, Friedman DN, Kelvin JF. The intersection of financial toxicity and family building in young adult cancer survivors. Cancer. 2018;124(16):3284-3289. doi:10.1002/cncr.31588
3. Collado L, Brownell I. The crippling financial toxicity of cancer in the United States. Cancer Biol Ther. 2019;20(10):1301-1303. doi:10.1080/15384047.2019.1632132
