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The impact of rising insurance deductibles and out-of-pocket healthcare costs on patients and their families continues to be a generous source of headline news.
The healthcare costs insured patients are expected to shoulder today compared to just a decade ago are alarming. According to a recent nationwide poll conducted by the Los Angeles Times in partnership with the Kaiser Family Foundation, individuals covered by employer-provided health plans were expected to pay an average of $379 in annual deductibles in 2006. In 2018, that number grew to $1,350. It should go without saying that salaries have not kept up with this rate of inflation.
In the LA Times survey, one in six respondents covered by employer-based insurance said they had to make "difficult sacrifices" to pay for healthcare this past year—including cutting back on food, moving in with friends or family, or taking extra jobs. One in five said their healthcare costs had depleted all or most of their savings.
Other studies reveal an even bleaker picture for patients with cancer. According to a June 7 report from the Centers for Disease Control (CDC), 25 percent of cancer survivors report difficulty paying their medical bills, and 33 percent report psychological hardship (e.g., worry about these bills). The CDC also found that the average annual out-of-pocket healthcare spending for cancer survivors was significantly higher ($1,000) compared to those no history of cancer ($622). As the population of cancer survivors grows, the number of patients shouldering this financial burden will also grow.
In its report, the CDC cites evidence that associates adequate insurance coverage with better outcomes for patients with cancer. While the report notes that having no insurance is strongly associated with both material and psychological hardship, it also notes that even patients with private insurance report struggling to cover medical costs, going into debt, and filing for bankruptcy.
Given the evidence linking financial security with more positive clinical outcomes, the CDC recommends that cancer care providers implement proactive strategies to alleviate the disproportionate financial hardship experienced by many cancer survivors: “These strategies include systematic screening for financial hardship at cancer diagnosis and throughout cancer care, integration of discussions about the potential for adverse financial consequences of treatments in shared treatment decision-making, and linkage of patients and survivors to available resources to ensure access to high-quality, evidence-based care.”
These recommendations align with the Association of Community Cancer Centers (ACCC) Financial Advocacy Services Guidelines. Released in 2018, the guidelines were developed with the goal of supporting cancer programs and practices in proactively addressing financial issues along the cancer care continuum to help assist patients in accessing quality care. Since 2012, ACCC through its Financial Advocacy Network, has been helping cancer care providers to work with patients to prevent the financial toxicity that can come with a cancer diagnosis. ACCC's Financial Advocacy Network offers tools and training for healthcare professionals so that they can proactively work with patients to integrate financial health into the cancer care continuum.
The CDC estimates that there are 16.9 million persons in the U.S. who are cancer survivors. As that population expands, many more will struggle to afford their care even after that care has long concluded. Helping patients reduce their out-of-pocket costs for cancer care is essential to promoting access to high-quality care, as well as quality of life after that care has done its job.