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Current Practices for Screening and Management of Financial Distress at NCCN Member Institutions.

Publication ,  Journal Article
Khera, N; Sugalski, J; Krause, D; Butterfield, R; Zhang, N; Stewart, FM; Carlson, RW; Griffin, JM; Zafar, SY; Lee, SJ
Published in: J Natl Compr Canc Netw
July 2020

BACKGROUND: Financial distress from medical treatment is an increasing concern. Healthcare organizations may have different levels of organizational commitment, existing programs, and expected outcomes of screening and management of patient financial distress. PATIENTS AND METHODS: In November 2018, representatives from 17 (63%) of the 27 existing NCCN Member Institutions completed an online survey. The survey focused on screening and management practices for patient financial distress, perceived barriers in implementation, and leadership attitudes about such practices. Due to the lack of a validated questionnaire in this area, survey questions were generated after a comprehensive literature search and discussions among the study team, including NCCN Best Practices Committee representatives. RESULTS: Responses showed that 76% of centers routinely screened for financial distress, mostly with social worker assessment (94%), and that 56% screened patients multiple times. All centers offered programs to help with drug costs, meal or gas vouchers, and payment plans. Charity care was provided by 100% of the large centers (≥10,000 unique annual patients) but none of the small centers that responded (<10,000 unique annual patients; P=.008). Metrics to evaluate the impact of financial advocacy services included number of patients assisted, bad debt/charity write-offs, or patient satisfaction surveys. The effectiveness of institutional practices for screening and management of financial distress was reported as poor/very poor by 6% of respondents. Inadequate staffing and resources, limited budget, and lack of reimbursement were potential barriers in the provision of these services. A total of 94% agreed with the need for better integration of financial advocacy into oncology practice. CONCLUSIONS: Three-fourths of NCCN Member Institutions reported screening and management programs for financial distress, although the actual practices and range of services vary. Information from this study can help centers benchmark their performance relative to similar programs and identify best practices in this area.

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Published In

J Natl Compr Canc Netw

DOI

EISSN

1540-1413

Publication Date

July 2020

Volume

18

Issue

7

Start / End Page

825 / 831

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Oncology & Carcinogenesis
  • Neoplasms
  • Medical Oncology
  • Humans
  • Health Expenditures
  • Financing, Personal
  • Economic Status
  • Delivery of Health Care
  • 4203 Health services and systems
 

Citation

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Khera, N., Sugalski, J., Krause, D., Butterfield, R., Zhang, N., Stewart, F. M., … Lee, S. J. (2020). Current Practices for Screening and Management of Financial Distress at NCCN Member Institutions. J Natl Compr Canc Netw, 18(7), 825–831. https://doi.org/10.6004/jnccn.2020.7538
Khera, Nandita, Jessica Sugalski, Diana Krause, Richard Butterfield, Nan Zhang, F Marc Stewart, Robert W. Carlson, Joan M. Griffin, S Yousuf Zafar, and Stephanie J. Lee. “Current Practices for Screening and Management of Financial Distress at NCCN Member Institutions.J Natl Compr Canc Netw 18, no. 7 (July 2020): 825–31. https://doi.org/10.6004/jnccn.2020.7538.
Khera N, Sugalski J, Krause D, Butterfield R, Zhang N, Stewart FM, et al. Current Practices for Screening and Management of Financial Distress at NCCN Member Institutions. J Natl Compr Canc Netw. 2020 Jul;18(7):825–31.
Khera, Nandita, et al. “Current Practices for Screening and Management of Financial Distress at NCCN Member Institutions.J Natl Compr Canc Netw, vol. 18, no. 7, July 2020, pp. 825–31. Pubmed, doi:10.6004/jnccn.2020.7538.
Khera N, Sugalski J, Krause D, Butterfield R, Zhang N, Stewart FM, Carlson RW, Griffin JM, Zafar SY, Lee SJ. Current Practices for Screening and Management of Financial Distress at NCCN Member Institutions. J Natl Compr Canc Netw. 2020 Jul;18(7):825–831.

Published In

J Natl Compr Canc Netw

DOI

EISSN

1540-1413

Publication Date

July 2020

Volume

18

Issue

7

Start / End Page

825 / 831

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Oncology & Carcinogenesis
  • Neoplasms
  • Medical Oncology
  • Humans
  • Health Expenditures
  • Financing, Personal
  • Economic Status
  • Delivery of Health Care
  • 4203 Health services and systems