Abstract
PURPOSE National organizations encourage communication about costs of cancer care; however, few data are available on health system models for identifying and assisting patients with financial distress (FD). We report the feasibility and acceptability of a financial counseling (FC) intervention for patients who receive chemotherapy at a comprehensive cancer center. MATERIALS AND METHODS Patients were randomly assigned 1:1 to FC or standard care. The FC arm received education, financial assistance screening, and an estimation tool with total billed charges and out-of-pocket (OOP) cost of one cycle of chemotherapy from a financial counselor through phone call and in-person visit. Participants completed measures of FD, health-related quality of life, and acceptability. RESULTS Ninety-five participants enrolled (mean age, 61 years; 72% white; 50% commercially insured), with a 32% attrition rate between assessments. Rates of completion for the phone call, in-person, and entire intervention were 98%, 47%, and 30%, respectively. The OOP estimation tool was considered understandable and acceptable to the majority of participants. No significant changes in FD were found between arms. Emotional functioning was negatively associated with having high FD (95% CI, 20.13379 to 20.013; P = .0189). Being married was associated with a decrease in log-odds of having high FD (b = 21.916; 95% CI, 23.358 to 20.475; P = .0092). CONCLUSION Implementation of an FC program that provides transparent cost data is feasible and acceptable. Incorporation of FC into clinical workflow, including phone counseling, is important to improve feasibility. Additional work is needed to develop tailored educational materials that are patient specific.
| Original language | English (US) |
|---|---|
| Pages (from-to) | E202-E210 |
| Journal | Journal of oncology practice |
| Volume | 15 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2019 |
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ASJC Scopus subject areas
- Oncology
- Oncology(nursing)
- Health Policy
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Piloting a financial counseling intervention for patients with cancer receiving chemotherapy. / Kircher, Sheetal Mehta; Yarber, Jessica; Rutsohn, Josh; Guevara, Yanina; Lyleroehr, Madison; Jackson, Hannah Alphs; Walradt, Jessica; Desai, Bijal; Mulcahy, Mary Frances; Kalyan, Aparna; Benson III, Al B; Agulnik, Mark; Mohindra, Nisha Anjali; DeSouza, Jonas; Garcia, Sofia F.
In: Journal of oncology practice, Vol. 15, No. 3, 01.03.2019, p. E202-E210.Research output: Contribution to journal › Article
TY - JOUR
T1 - Piloting a financial counseling intervention for patients with cancer receiving chemotherapy
AU - Kircher, Sheetal Mehta
AU - Yarber, Jessica
AU - Rutsohn, Josh
AU - Guevara, Yanina
AU - Lyleroehr, Madison
AU - Jackson, Hannah Alphs
AU - Walradt, Jessica
AU - Desai, Bijal
AU - Mulcahy, Mary Frances
AU - Kalyan, Aparna
AU - Benson III, Al B
AU - Agulnik, Mark
AU - Mohindra, Nisha Anjali
AU - DeSouza, Jonas
AU - Garcia, Sofia F
PY - 2019/3/1
Y1 - 2019/3/1
N2 - PURPOSE National organizations encourage communication about costs of cancer care; however, few data are available on health system models for identifying and assisting patients with financial distress (FD). We report the feasibility and acceptability of a financial counseling (FC) intervention for patients who receive chemotherapy at a comprehensive cancer center. MATERIALS AND METHODS Patients were randomly assigned 1:1 to FC or standard care. The FC arm received education, financial assistance screening, and an estimation tool with total billed charges and out-of-pocket (OOP) cost of one cycle of chemotherapy from a financial counselor through phone call and in-person visit. Participants completed measures of FD, health-related quality of life, and acceptability. RESULTS Ninety-five participants enrolled (mean age, 61 years; 72% white; 50% commercially insured), with a 32% attrition rate between assessments. Rates of completion for the phone call, in-person, and entire intervention were 98%, 47%, and 30%, respectively. The OOP estimation tool was considered understandable and acceptable to the majority of participants. No significant changes in FD were found between arms. Emotional functioning was negatively associated with having high FD (95% CI, 20.13379 to 20.013; P = .0189). Being married was associated with a decrease in log-odds of having high FD (b = 21.916; 95% CI, 23.358 to 20.475; P = .0092). CONCLUSION Implementation of an FC program that provides transparent cost data is feasible and acceptable. Incorporation of FC into clinical workflow, including phone counseling, is important to improve feasibility. Additional work is needed to develop tailored educational materials that are patient specific.
AB - PURPOSE National organizations encourage communication about costs of cancer care; however, few data are available on health system models for identifying and assisting patients with financial distress (FD). We report the feasibility and acceptability of a financial counseling (FC) intervention for patients who receive chemotherapy at a comprehensive cancer center. MATERIALS AND METHODS Patients were randomly assigned 1:1 to FC or standard care. The FC arm received education, financial assistance screening, and an estimation tool with total billed charges and out-of-pocket (OOP) cost of one cycle of chemotherapy from a financial counselor through phone call and in-person visit. Participants completed measures of FD, health-related quality of life, and acceptability. RESULTS Ninety-five participants enrolled (mean age, 61 years; 72% white; 50% commercially insured), with a 32% attrition rate between assessments. Rates of completion for the phone call, in-person, and entire intervention were 98%, 47%, and 30%, respectively. The OOP estimation tool was considered understandable and acceptable to the majority of participants. No significant changes in FD were found between arms. Emotional functioning was negatively associated with having high FD (95% CI, 20.13379 to 20.013; P = .0189). Being married was associated with a decrease in log-odds of having high FD (b = 21.916; 95% CI, 23.358 to 20.475; P = .0092). CONCLUSION Implementation of an FC program that provides transparent cost data is feasible and acceptable. Incorporation of FC into clinical workflow, including phone counseling, is important to improve feasibility. Additional work is needed to develop tailored educational materials that are patient specific.
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U2 - 10.1200/JOP.18.00270
DO - 10.1200/JOP.18.00270
M3 - Article
VL - 15
SP - E202-E210
JO - Journal of Oncology Practice
JF - Journal of Oncology Practice
SN - 1554-7477
IS - 3
ER -