QIM20-120: Financial Toxicity: Building a Patient Centered Program

Over the last 10 years rising healthcare costs has had a damaging impact on cancer patients and their families. Novel agents, high cost therapies, shifting premiums, high deductibles and copay’s are causing patients to choose between appropriate therapies and supporting themselves and their families. The Cleveland Clinic Cancer Center has developed initiatives to help manage factors that contribute to financial toxicity. Our journey began in the 1990‘s hiring financial counselors, advancing throughout the years to include finance specialists in 2000. These positions supported patient education, collections and drug authorization along with co- pay assistance. Volumes and narrow networks drove us to huddles for all new patients and the hiring financial navigators. These initiatives drove two goals, access within 7 days and decreasing high out of pockets. Our huddles include a clinical provider, administrators, revenue cycle employees, and scheduling coordinators. We focus on doing the right thing for the patient, and at times that means we help the patient find services in network to reduce the financial burden. Finance navigators are used to improve cost transparency, increase the capture of co-pay assistance and drug replacement, and align patients to advocacy groups and agencies. We have also engaged our philanthropic community to assist with mortgage payments, house repairs and utility bills to meet the non-medical needs. The results of our work has generated over $7 million dollars in 2018 that help our patients. I believe there are other practice models and community assets we could leverage to help in this very important life dynamic. Continuous improvement will drive the success of these programs.

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Corresponding Author: Kimberly Bell, RN, MBA
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