Background: The financial burden associated with a cancer diagnosis and treatment is often referred to as financial toxicity. The Cleveland Clinic has actively been seeking mechanisms to reduce the financial toxicity of cancer care through the development of a financial navigation team. The team seeks to identify and target any financial barriers patients can experience with cancer treatment and reduce the financial hardship associated with cancer care.
Objectives: Our goal is to provide holistic care, assessing barriers to care. This methodology has allowed us to not only assist the patient within the Cleveland Clinic but to also connect them with organizations within their local communities. Cleveland Clinic’s financial navigators within the oncology service line will provide an out-of-pocket estimate to 100% of our first-time chemotherapy treatment patients. The financial navigation team reaches out to each patient and educates them on out-of-pocket costs associated with their care, any available assistance programs, and helps to identify any other financial barriers within the home.
Methods: Multiple components aid our team in its efforts to navigate every patient. A report was built to identify first-time treatment patients who would require an outreach contact. The financial navigators use this report for targeted outreach calls. A standardized documentation note was developed to be utilized by all financial navigators within the oncology service line. Utilization of the standardized documentation template allowed our analytics team to build a dashboard to track compliance with the 100% target.
Results: Implementation began in December 2017, and the compliance rate with out-of-pocket estimate education has ranged from 96% to 100% through July 2019.
Conclusion: Financial navigation goes beyond the walls of the Cleveland Clinic. We strive to ensure the patient knows we are with them every step of the way by building relationships with the patients, breaking down barriers, and assisting patients with resources to ease their financial burden. This type of program can be duplicated at other facilities, and it is our hope that other organizations consider the importance of financial navigators as a means to reduce financial toxicity in cancer patients.
Sources
- Bell K, Monak MM, Rothacker A, et al. Patient Financial Burden: Considerations for Oncology Care and Access. One organization’s approach to addressing financial toxicity. www.managedcaremag.com/sites/default/files/downloads/patient-financial-burden_cleveland-clinic_wp.pdf. 2019.
- Bernard DS, Farr SL, Fang Z. National estimates of out-of-pocket health care expenditure burdens among nonelderly adults with cancer: 2001 to 2008. J Clin Oncol. 2011;29:2821-2826.
- Monak M, Bell K, Whitt A. Development of a financial navigation program to ease the burden of financial toxicity. Cleveland Clinic, Taussig Cancer Center, Cleveland Clinic Foundation. 2019. Abstract.
- Zullig LL, Wolf S, Vlastelica L, et al. The role of patient financial assistance programs in reducing costs for cancer patients. J Manag Care Spec Pharm. 2017;23:407-411.