ASPO Abstracts
Interventions to Address the Financial Burden of Cancer Care: Recommendations from the Field
Category: Financial Hardship Associated with Cancer
Conference Year: 2020
Abstract Body:
Purpose: To identify and understand recommendations for addressing cancer patients’ financial barriers
identified by financial and social support staff at cancer centers across seven states.
Methods: Members of the Cancer Prevention and Control Research Network (CPCRN) rural cancer workgroup
conducted 35 interviews with staff who provided financial navigation services to cancer patients. Participants
were recruited from 29 cancer centers in both rural and urban settings, including National Cancer Institute-
designated, and Commission on Cancer (CoC)-accredited, and non-accredited centers. A semi-structured
interview guide was used to identify best practices in assessing and addressing financial distress. Interviews
lasted approximately 60 minutes, were audio recorded, and transcribed verbatim. A codebook was developed
from the research questions, interview guide and discussion with research teams. Transcripts were double
coded for thematic analysis, and facilitated with Dedoose, a qualitative software program.
Results: Current, effective practices identified by participants included using distress screening tools, patient
education visits with a financial counselor, tailored resource lists, patient tracking systems, and the use of
telemedicine for rural cancer patients. Participants recommended both policy and clinical changes to address
financial toxicity. Policy changes included fixing the “broken system” of policies related to health insurance,
pharmaceutical companies, and job protection for patients and caregivers. Clinical recommendations included
addressing financial concerns prior to treatment initiation through required financial counselor meetings,
development of comprehensive resources and networks for staff to assist patients, financial training for cancer
center staff, and improving transportation and lodging opportunities for patients.
Conclusions: Cancer center staff providing financial navigation services identified core services related to
assessment, education, and mitigation of financial distress among cancer patients. They also proposed policy-,
system-, and clinic-level approaches to improving reduce costs borne by patients, which may help address the
growing challenge of financial toxicity among cancer patients.
Keywords: financial toxicity; cancer centers; disparities; qualitative interviews