Guidelines aim to take financial advocacy ‘to the next step’
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Association of Community Cancer Centers’ Financial Advocacy Network released consensus-based guidelines to help practices prevent, identify or mitigate financial hardships among their patients.
“Insurance in health care is ever-changing, and there has been no way for us to keep up with all of those changes and stay consistent across all the clinics and health care systems,” Lori Schneider, operations manager at Green Bay Oncology, as well as past chairwoman of the Financial Advocacy Network and current ACCC board member, told Healio. “Our goal is to create guidelines that will help clinics and health care systems take care of their patients. We want to set a bar we can then measure ourselves against, but also help each other learn and grow and take it to the next step.”
Healio spoke with Schneider about the group convened to create the guidelines, how they were developed and how she hopes they will help minimize patients’ financial obstacles.
Healio: How did you assemble the group that developed these guidelines?
Schneider: We had people from four organizations outside ACCC — Triage Cancer, Academy of Oncology Nurse & Patient Navigators, CancerCare and the National Patient Advocacy Foundation. We also had 39 representatives from different health care organizations. These were experts either in literature or as hands-on advocates or navigators. So, there was a vast array of people who brought different perspectives to build consensus.
Healio: How did you develop the guidelines?
Schneider: To start, we asked open-ended questions about whether a particular issue should be a guideline, or whether it was something we should consider or discuss further. We went through a very long list of questions and kept narrowing them down.
For example, one question we considered was when you have a newly diagnosed patient starting treatment at your clinic, do you meet with that patient [to discuss financial issues] upfront, or do you wait and do it a couple of appointments in? Or do you have someone who takes care of that patient once the patient has questions? Should it be a proactive approach or a reactive approach? We decided we wanted to be proactive, but how do we help the clinics that perhaps are smaller and perhaps don’t have the tools to get to that proactive point?
Healio: What are some of the key topics addressed in the guidelines?
Schneider: We broke our guidelines into three categories: financial advocacy services and functions, which include more hands-on processes; program management functions, which includes staffing, training and infrastructure; and partner engagement functions, which relates to how our partners help us spread the word that these tools are out there. We’re looking at the full approach from that person at the hands-on level all the way to management or the C suite. We also want to get input from our partners to ensure we have a collaboration dedicated to making sure our patients get what they need.
Healio: What is the biggest financial challenge patients with cancer face?
Schneider: Patients are stretched financially due to high premiums, as well as high out-of-pocket costs and deductibles. Some marketplace plans have deductibles and out-of-pocket maximums of $16,000 to $18,000. If a patient goes to a cancer center that requires financial clearance, they may have to pay something upfront. It truly takes a village to help patients navigate the health care system, the insurance system and the financial system.
Healio: How will these guidelines help patients?
Schneider: These guidelines provide tools that clinicians can use to help their patients navigate the financial aspects of care. We still hear about clinics that are just starting and haven’t had training in this area and don’t know where to go. Those of us who have been in this role or in this landscape for a while have tools to offer them, so they don’t have to start from scratch. With these tools, it’s not going to take them hours to figure out their next step. We’re going to provide them these guidelines with the goal of saying, “Here are the tools you need. We’re going to help you get off the ground, and we’re going to help you cruise along. As a network, we are all here to help you continue to grow and get that program up to par, where you want it.”
Healio: How can oncologists best use these guidelines to help their patients?
Schneider: It’s important for oncologists to understand there are tools available and to have conversations with patients about this issue. They shouldn’t ignore the financial side, as this is a huge barrier and burden for patients. We don’t necessarily expect physicians to be able to navigate this world, but we do expect them to help connect patients with available resources or refer patients to a navigator within the system to ensure they get what they need. By treating the financial burden, we can help relieve some of the stress and worry, and that frees the patient to focus on taking care of themselves.
Reference:
- Association of Community Cancer Centers Financial Advocacy Network. Financial Advocacy Services Guidelines. Available at: https://www.accc-cancer.org/docs/projects/financial-advocacy/financialadvocacyservicesguidelines.pdf?sfvrsn=39de3574_6. Accessed Jan. 29, 2024.
For more information:
Lori Schneider can be reached at Association of Community Cancer Centers, 1801 Research Blvd., Suite 400, Rockville MD 20850; email: lori.schneider@gboncology.com.
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