Why I’m Hopeful about Lowering Cancer Costs: New Tools for Financial Navigation

As an Oncology Financial Navigator, I have found that patients begin worrying about the costs of their cancer care almost immediately. Of course, there’s the initial shock of the diagnosis, but the next thing they begin to think about is, “How much is this going to cost me and my family? Can I afford it? Will my insurance cover my treatments?” These urgent questions start to spin through their minds.

Unfortunately, there are valid reasons to be concerned. Cancer patients are experiencing rapidly rising out-of-pocket costs. The term “financial toxicity” has emerged to describe the negative impact of these costs on patients’ quality of life, treatment adherence, and risk of mortality. What’s more, many hospitals are also struggling due to the bad debt they’ve incurred because of patients’ inability to pay.

Cancer programs across the country have implemented financial navigation programs to address the burden of financial toxicity on patients, their families, and healthcare organizations. I was one of the founding financial navigators at the Cowell Family Cancer Center, which is part of the largest healthcare system in northern Michigan. Since 2013, the program has conducted insurance optimization, assisted with insurance and other program enrollment, and sought out other forms of assistance through foundations and free drug programs.

The challenge is that our work has been manual and decentralized, which limits how many patients we can reach and our efficiency. It also makes it difficult for us to measure our impact and demonstrate the program’s value to patients and hospital administrators. In addition, most patients self-select into the program, so those with the greatest financial risk may not benefit from assistance.

The reason I’m hopeful, however, is that new tools have emerged that can dramatically improve our ability to ease the financial burden of cancer. At the Cowell Family Cancer Center, we recently completed a pilot study in which we tested the effectiveness of a financial navigation platform called TailorMed.

This web-based tool improved our work in a variety of ways. By interfacing with the cancer center’s electronic health record, the platform identified those patients who were most at risk for financial toxicity, based on their cancer diagnosis, treatment plan, insurance, and demographics. It projected the patients’ out-of-pocket costs across the entire medical journey and then suggested a number of opportunities for cost savings, including co-pay assistance, help with living expenses, and government programs.

Using this technology, we were able to secure assistance for almost 200 high-priority patients over the course of the eight-month study. I’m proud to say that the total savings were more than $3.5 million. Had the study taken place during open enrollment period, these numbers may have been even higher, as the software suggested opportunities such as enrolling in Medicare, Marketplace plans, etc.

Financial aid supported a variety of medical services that were part of our patients’ course of treatment. The technology also enabled us to streamline and modify our workflow. Rather than manually searching for relevant opportunities and keeping track of the application status for each patient, the platform allowed us to access those opportunities directly, displayed the entire life cycle of the application process, and immediately tracked the value of the savings. By reducing inefficiencies, we were able to provide higher-quality financial navigation to those who needed it so urgently.

My hope that is over time, more hospitals will harness the power of technology to improve their financial navigation programs. Just as cancer centers are investing in new, cutting-edge treatments, I believe it’s equally important that they invest in the latest tools to reduce patients’ financial distress.

We cannot ignore the staggering costs of cancer care and their impact on patients and their families. By addressing these challenges head on — with the most sophisticated tools at our disposal — we will not only save costs. We will save lives.