CCSG Supplement: Financial Hardship During Cancer Treatment

Abstract Patients with hematologic cancers, such as leukemia, lymphoma and multiple myeloma could be at higher risk for experiencing financial toxicity as a potential side effect of treatment. While hematologic cancers may trail behind other cancers in incidence and death rates, the high costs of care associated with treating them warrant further investigation. Studies have shown that lower SES is associated with poor survival for blood cancers, however the financial impact of HCT on patients and caregivers is not well established. Establishing an inpatient financial navigation program at MCC’s Division of Hematology and Blood & Marrow Transplant (BMT) could help address these gaps while reducing financial toxicity and stress for patients and caregivers. The overall goal of this administrative supplement is to develop and evaluate a patient- centered, interdisciplinary team-based approach to enhance financial navigation services/assistance. The central hypothesis guiding this research is that financial navigation program will be effective in identify financial hardship and provide financial assistance within a low-income, rural hematology and BMT oncology population. The rationale for the proposed research builds on the premise that the early identification of patients at risk for financial toxicity allows the health system to proactively address the issue with the patient by linking them with needed financial assistance resources, which in turn helps improve patient outcomes, and increase financial benefits for patients and financial return on investment (ROI) for health systems. Furthermore, for clinicians, the availability of an interdisciplinary team to help supply cost information and address financial concerns will alleviate the reasons for not discussing financial issues with patients. To support our overall objective, this application will address the following specific aims: Aim 1: Conduct formative evaluation to identify and describe appropriate pathways and workflows to connect patients and caregivers with financial navigation services. Aim 2: Evaluate the feasibility and acceptability of a financial navigation program and assess its impact on proactively identifying and addressing financial hardship, reducing financial distress and improving QOL among patients and caregivers throughout the cancer care continuum. Aim 3: Assess the impact of the financial navigation program on financial benefits for patients/caregivers and institutional ROI for health systems to help address sustainability. The proposed financial navigation program is designed to address patient, provider and system- level factors associated with decreasing cancer-related financial hardship. If effective, this model can be expanded to other inpatient settings at MCC and/or other cancer centers, including those in MCC’s affiliate network.