Financial Advocacy OI Articles

Leveraging the Discussions of Cost App to reduce financial toxicity and improve treatment cost communication.

The Centers for Medicare & Medicaid Services and the American Medical Association's (AMA's) finalized coding updates for calendar year 2022.

The Medicare Physician Fee Schedule (MPFS) for calendar year 2022.

The Hospital Outpatient Prospective Payment System (HOPPS) for calendar year 2022.

Put yourself first: this mantra is especially important today as we continue to grapple with the implications and fallout from the COVID-19 global pandemic.

As we turn the corner toward 2022, for oncology to drive equity forward: We need every member and every discipline, patient, leader, payer, industry partner, and innovator working together to provide the most equitable care possible in a sustainable way.

In addition to the global pandemic, ongoing lawsuits from referenced biologics' manufacturers suing biosimilar manufacturers are having a negative impact on the development and approval of new biosimilars.

In an interview with Oncology Issues, Dr. Weiss shares why she believes this work is important in all levels of healthcare—from the clinic to the boardroom.

There has been a flurry of activity from the Centers for Medicare & Medicaid Services, Health and Human Services, and Health Resources and Services Administration, including the release of the CMS calendar year (CY) 2022 proposed rules for the Medicare Physician Fee Schedule and Hospital Outpatient Prospective Payment System. Below is a summary of how these notifications may impact oncology.

Many times, being present, allowing the grief, and letting our patients know they aren’t alone is the only “treatment” we have. So, what sustains us? How do we do this every day?

At Northwest Medical Specialties, we, too, face challenges from staff stress and exhaustion. To address and overcome these challenges, our management team has made it a priority to bolster the resiliency of our staff.

Rather than fielding its annual Trending Now in Cancer Care survey while cancer programs were experiencing unprecedented challenges due to the extended public health emergency, ACCC chose to facilitate conversations with its members to capture the lived experiences of the most pertinent issues impacting oncology practice and care delivery.

Key results from a national survey show a range of new initiatives.

Cancer programs are facing multiple challenges related to treating patients in a COVID-19 environment. Cancer programs need to deploy systems and processes to help navigate these patients into the healthcare system and to work through the backlog of new patients with cancer as quickly as possible within existing resources.

The 2021 Medicare Physician Fee Schedule proposed the following changes specific to telehealth.

Our only means of contact with a patients was through his friend who lived near the abandoned house the patient stayed in and who could take his phone to the patient if needed. After a quick search online, I found two websites that offered cell phones to low-income patients at little to no cost to them.

For people with cancer, figuring out how to pay for treatment is one of their greatest concerns. To address these concerns many cancer programs have developed and implemented financial navigation programs.

This innovative program provides coordinated whole-person care, ensuring that patients receive the support they need through psychosocial counseling, social support, rehabilitation services, financial counseling, nurse navigation, nutritional intervention, transportation assistance, physical therapy, tertiary care referrals, and medication assistance. The GPS approach helps the cancer care team proactively identify patient needs and prepare patients for treatment.

Many cancer program leaders say that improving patient access and the patient-centeredness of care delivery are key strategic imperatives.

As the price of new cancer treatments continues to rise, physicians in both the inpatient and outpatient settings need to factor cost as well as efficacy into treatment plans. Julie Kennerly-Shah, PharmD, MS, MHA, facilitates the Hematology Oncology Pharmacy and Therapeutics (P&T) Committee at The Ohio State University Comprehensive Cancer Center, determining which agents will be available to providers for treatment and if restrictions will be placed on those medications.

While financial navigation programs ease the burden of financial toxicity on patients with cancer and help healthcare organizations with revenue loss, the manual nature of the process is challenging for navigators and financial advocates. Cowell Family Cancer Center piloted a financial navigation software program to analyze the effects of automation on productivity, workflow, and organizational alignment.

Bridging the Psychosocial and Financial

Cancer programs are all on different parts of an ongoing journey to provide better financial counseling, navigation, and advocacy services to patients. Since 2011, ACCC has led national efforts to provide practical education, training, tools, and resources through its Financial Advocacy Network (FAN) initiative.

The Lancaster General Health Foundation has one fund that is devoted solely to supporting the financial needs of patients receiving treatment at the Cancer Institute: the Cancer Patient Support Fund.

Cancer patients frequently experience financial burden and distress because of the high out-of-pocket costs associated with their treatments, the indirect and non-medical costs related to medical care, and the potential for lost income or employment while undergoing treatment.