Delivery of Financial Navigation Services Within National Cancer Institute-Designated Cancer Centers.
Journal
JNCI cancer spectrum
ISSN: 2515-5091
Titre abrégé: JNCI Cancer Spectr
Pays: England
ID NLM: 101721827
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
received:
07
12
2020
revised:
05
03
2021
accepted:
07
04
2021
entrez:
5
7
2021
pubmed:
6
7
2021
medline:
6
7
2021
Statut:
epublish
Résumé
Cancer centers have a responsibility to help patients manage the costs of their cancer treatment. This article describes the availability of financial navigation services within the National Cancer Institute (NCI)-designated cancer centers. Data were obtained from the NCI Survey of Financial Navigation Services and Research, an online survey administered to NCI-designated cancer centers from July to September 2019. Of the 62 eligible centers, 57 completed all or most of the survey, for a response rate of 90.5%. Nearly all cancer centers reported providing help with applications for pharmaceutical assistance programs and medical discounts (96.5%), health insurance coverage (91.2%), assistance with nonmedical costs (96.5%), and help understanding medical bills and out-of-pocket costs (85.9%). Although other services were common, in some cases they were only available to certain patients. These services included direct financial assistance with medical and nonmedical costs and referrals to outside organizations for financial assistance. The least common services included medical debt management (63.2%), detailed discussions about the cost of treatment (54.4%), and guidance about legal protections (50.1%). Providing treatment cost transparency to patients was reported as a common challenge: 71.9% of centers agreed or strongly agreed that it is difficult to determine how much a cancer patient's treatment will cost, and 70.2% of oncologists are reluctant to discuss financial issues with patients. Cancer centers provide many financial services and resources. However, there remains a need to build additional capacity to deliver comprehensive financial navigation services and to understand the extent to which patients are referred and helped by these services.
Sections du résumé
Background
Cancer centers have a responsibility to help patients manage the costs of their cancer treatment. This article describes the availability of financial navigation services within the National Cancer Institute (NCI)-designated cancer centers.
Methods
Data were obtained from the NCI Survey of Financial Navigation Services and Research, an online survey administered to NCI-designated cancer centers from July to September 2019. Of the 62 eligible centers, 57 completed all or most of the survey, for a response rate of 90.5%.
Results
Nearly all cancer centers reported providing help with applications for pharmaceutical assistance programs and medical discounts (96.5%), health insurance coverage (91.2%), assistance with nonmedical costs (96.5%), and help understanding medical bills and out-of-pocket costs (85.9%). Although other services were common, in some cases they were only available to certain patients. These services included direct financial assistance with medical and nonmedical costs and referrals to outside organizations for financial assistance. The least common services included medical debt management (63.2%), detailed discussions about the cost of treatment (54.4%), and guidance about legal protections (50.1%). Providing treatment cost transparency to patients was reported as a common challenge: 71.9% of centers agreed or strongly agreed that it is difficult to determine how much a cancer patient's treatment will cost, and 70.2% of oncologists are reluctant to discuss financial issues with patients.
Conclusions
Cancer centers provide many financial services and resources. However, there remains a need to build additional capacity to deliver comprehensive financial navigation services and to understand the extent to which patients are referred and helped by these services.
Identifiants
pubmed: 34222790
doi: 10.1093/jncics/pkab033
pii: pkab033
pmc: PMC8242138
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
Published by Oxford University Press 2021. This work is written by US Government employees and is in the public domain in the US.
Références
J Clin Oncol. 2015 Jul 1;33(19):2190-6
pubmed: 25987701
Oncologist. 2015 Oct;20(10):1199-204
pubmed: 26330457
J Clin Oncol. 2014 Feb 1;32(4):306-11
pubmed: 24366936
Oncologist. 2015 Sep;20(9):1092-8
pubmed: 26205738
Am J Manag Care. 2015 Sep;21(9):607-15
pubmed: 26618364
Pharmacoeconomics. 2018 Mar;36(3):259-261
pubmed: 29396743
J Cancer Surviv. 2019 Jun;13(3):406-417
pubmed: 31123985
Health Aff (Millwood). 2016 Dec 1;35(12):2297-2301
pubmed: 27920319
JAMA Oncol. 2015 Jun;1(3):273-4
pubmed: 26181165
Cancer Epidemiol Biomarkers Prev. 2013 Apr;22(4):561-70
pubmed: 23535024
J Clin Oncol. 2016 Mar 20;34(9):980-6
pubmed: 26811521
J Manag Care Spec Pharm. 2017 Feb;23(2):136-162
pubmed: 28125370
Health Aff (Millwood). 2009 May-Jun;28(3):827-34
pubmed: 19414893
J Natl Cancer Inst. 2016 Oct 20;109(2):
pubmed: 27754926
Cancer. 2013 Oct 15;119(20):3710-7
pubmed: 23907958
Support Care Cancer. 2019 Dec;27(12):4575-4585
pubmed: 30927112
Cancer. 2017 May 15;123(6):928-939
pubmed: 27893929
Support Care Cancer. 2018 Apr;26(4):1315-1321
pubmed: 29124417
Am J Health Syst Pharm. 2015 Dec 15;72(24):2190-5
pubmed: 26637519
J Natl Cancer Inst. 2008 Dec 17;100(24):1763-70
pubmed: 19066273
J Natl Cancer Inst. 2011 Jan 19;103(2):117-28
pubmed: 21228314
Cancer Med. 2020 May;9(9):3202-3210
pubmed: 32129946
J Clin Oncol. 2009 Aug 10;27(23):3868-74
pubmed: 19581533
Oncologist. 2013;18(4):381-90
pubmed: 23442307
J Clin Oncol. 2016 Jan 20;34(3):259-67
pubmed: 26644532
Support Care Cancer. 2018 Oct;26(10):3517-3526
pubmed: 29696426
Gynecol Oncol. 2012 Mar;124(3):437-43
pubmed: 22138013
J Oncol Pract. 2016 Mar;12(3):e281-8, 247-8
pubmed: 26883407
J Natl Compr Canc Netw. 2020 Jul;18(7):825-831
pubmed: 32634772
Am J Public Health. 2011 Jul;101(7):1248-52
pubmed: 21566039
J Clin Oncol. 2013 Oct 20;31(30):3749-57
pubmed: 24043731
J Natl Cancer Inst. 2018 Oct 1;110(10):1041-1047
pubmed: 30252079
Cancer Epidemiol Biomarkers Prev. 2018 Dec;27(12):1389-1397
pubmed: 30429132
J Oncol Pract. 2014 Sep;10(5):332-8
pubmed: 24865220
J Manag Care Spec Pharm. 2017 Apr;23(4):407-411
pubmed: 28345445
J Psychosoc Oncol. 2018 Jan-Feb;36(1):1-18
pubmed: 28786762
Patient. 2017 Jun;10(3):295-309
pubmed: 27798816
Health Aff (Millwood). 2016 Jan;35(1):54-61
pubmed: 26733701
J Clin Oncol. 2018 Feb 1;36(4):319-325
pubmed: 29016226
CA Cancer J Clin. 2018 Mar;68(2):153-165
pubmed: 29338071
Am J Manag Care. 2018 Mar;24(5 Suppl):S74-S79
pubmed: 29620814
Med Care. 2016 May;54(5):490-7
pubmed: 26900834
J Cancer Surviv. 2019 Feb;13(1):10-20
pubmed: 30357537
J Am Coll Radiol. 2019 Oct;16(10):1420-1424
pubmed: 31585660
J Natl Cancer Inst. 2008 Jun 18;100(12):888-97
pubmed: 18544740
J Oncol Pract. 2018 Feb;14(2):e122-e129
pubmed: 29272200
Cancer. 2015 Nov 15;121(22):4025-34
pubmed: 26348120
J Natl Compr Canc Netw. 2020 Jul;18(7):915-916
pubmed: 32634777
Health Aff (Millwood). 2019 Oct;38(10):1752-1761
pubmed: 31553631