ASPO Abstracts
Financial Navigation Staff Perspectives on the Patients' Financial Burden of Cancer Care
Category: Financial Hardship Associated with Cancer
Conference Year: 2020
Abstract Body:
Purpose: To describe cancer patients' experiences with financial burden as identified by financial navigation
staff at cancer centers.
Methods: Seven research teams from 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 including National Cancer Institute-designated,
Commission on Cancer (CoC), and non-CoC cancer centers. A semi-structured interview guide included
questions on financial challenges experienced by patients and how healthcare teams assess and address
financial distress. Interviews lasted approximately 1 hour, were audio recorded, and transcribed. A codebook
was developed from the interview guide and preliminary transcripts; transcripts were double coded for thematic
analysis.
Results: Two key themes emerged: a need for improved patient-provider communication and the multi-faceted
impact of financial distress on patients. Patients rarely expressed frustration about a lack of communication
with their provider regarding cost of care. However, when frustrations were expressed, it was due to lack of
transparency about prior authorization requirements and treatment costs. There is the perception that
discussions about cost are the primary responsibility of other members of the health care team (e.g., social
workers, financial navigators). Providers who initiated discussions with patients tailored treatment based upon
the patients' financial situation when possible. Financial navigation staff identified several ways that financial
distress affects patients and their families: emotional and psychological distress; refusal or delay of treatment;
lack of treatment adherence; inability to meet basic needs (e.g., housing, utilities.); and job loss.
Conclusions: Cancer-related financial distress can have a profound impact on patients' treatment and
outcomes. Discussion on cancer related costs between provider and patient vary. Transparent conversations
about treatment costs among patients, providers, and staff can help health care teams identify patients at risk
and mitigate the effects of cancer-related financial distress.
Keywords: financial toxicity; cancer centers; financial navigation