At least a quarter of patients at Memorial Sloan Kettering Cancer Center (MSK) in New York, NY, suffer with financial difficulties related to cancer treatment, suggesting a need for systems-based interventions to proactively assess financial toxicity (FT) risk and refer to resources, according to a study presented at the 2022 ASCO Quality Care Symposium.

“As FT interventions must consider the interdependent systems of barriers patients face, this project highlights efforts toward developing and testing hospital-based FT interventions through the creation of the MSK Affordability Working Group,” wrote Emeline Mariam Aviki, MD, MBA, Memorial Sloan Kettering Cancer Center.

Dr Aviki and colleagues organized a task force of physicians, nurses, social workers, and representatives from patient billing/financial services, health services research, and hospital administration and strategy to characterize FT among patients receiving treatment at MSK, and identify areas for systemic change.

Medical records from the years 2016 to 2018 were used to identify incidence of FT and current practices for providing financial assistance options. FT was defined as “having bill payment issues, applying for financial assistance, or expressing financial concerns to Social Work.” The task force evaluated this data, as well as post-analysis program processes.

A quarter of all records reviewed (22,187 of 89,283) showed evidence of patients experiencing FT. Only 22% of those experiencing payment issues were referred for financial assistance. To remedy this, the task force created an FT order set for providers to make direct referrals. The researchers identified 843 orders placed between March 2021 through February 2022. The FT order led to $836,000 in co-pay assistance and $13,500 in essential needs assistance.

An institutional working group was established at MSK with increased staffing and monetary support of patient-level pilot interventions.

“With at least 25% of patients at MSK experiencing financial difficulties related to cancer treatment, it was, and remains, vital to develop systems-based interventions to proactively assess FT risk and refer to tangible resources,” concluded Dr Aviki and colleagues, adding, “Planned future work includes implementation of universal FT screening with reflex referral to financial assistance, testing patient-level educational interventions, and developing policy/advocacy recommendations.”

Source

Aviki EM, Chino F, Gany F, et al. A multidisciplinary approach to operationalizing financial toxicity interventions: The MSK Affordability Working Group. Presented at: the 2022 ASCO Quality Care Symposium; September 30-October 1, 2022; Chicago, IL, and virtual; Abstract 2.