The ACCC Financial Advocacy Network is the leader in providing professional development training, tools, and resources that will empower providers to proactively integrate financial health into the cancer care continuum and help patients gain access to high-quality care for a better quality of life.
Mia Nutter, MBA, is a financial navigator at Winship Cancer Institute of Emory University in Atlanta, Ga. She is also a ACCC Financial Advocacy Network Advisory Committee member. She has worked in healthcare for 20 years and has been a patient advocate for the majority of that time. She began her career as a financial counselor in a level 5 trauma center in her organization’s Emergency Room, where she worked with patients to help them access financial assistance.
She then transitioned into the role of senior financial counselor, supporting the entire hospital system and assisting all patients with accessing financial assistance whose bills would soon be sent to collections and forgotten. Through this experience, Nutter saw many patients who could not afford their payments and who would file for bankruptcy once their accounts were sent to collections. Others would deplete their life savings to continue paying for their treatment. “Listening to patients and hearing story after story about how the cost of healthcare is too expensive and that they are often faced with paying for medications or paying for food, I knew I had to be an advocate and resource for these patients,” says Nutter.
Her passion and drive quickly led her to gain leadership opportunities and ultimately joined the revenue management team where she stayed for over 12 years. “I always felt my real passion was the connection I had with my patients and assisting them during their most challenging times—financially and emotionally—so I decided to focus on being a financial advocate,” says Nutter. “I became a financial navigator to be the voice of the patient because many patients will discuss their struggles and anxiety with financial debt with me more often than they would with their provider or family. By gaining their trust and proving that I am an advocate for them and that I will find a solution to their financial strain through various financial assistance programs, patients can focus on their treatment and healing.” Nutter has found that many patients will cancel their appointments or choose to not receive their oncology treatment because of their felt inability to afford treatment. But through education on the various community and manufacturer resources available that provide financial assistance, Nutter ensures patients’ treatment costs are 100 percent covered.
A patient was scheduled to receive infusion treatment for lymphoma on a Friday, but her healthcare plan was terminated the prior Monday without the patient’s knowledge. Due to a mix up in the patients’ insurance, a change in her premium cost, and decrease in work, Nutter’s patient was facing a serious question: “Do I continue treatment?”
While Nutter and the patient investigated into why the insurance was terminated and getting it reactivated, Nutter knew the patient couldn’t wait the month it would take get the insurance cleared. She immediately took the patient’s case to her cancer program’s financial assistance program and had the patient apply. She met with the Charity Department’s representatives and pleaded her case. Her patient needed chemotherapy treatment which could not be delayed, so she asked them to process the patient’s application immediately. Nutter gained the department’s approval within 24 hours to cover the costs of the patient’s clinic and chemotherapy treatments (costs up to $16,000). She also gained coverage for the patient if oncology surgery and/or inpatient stay was needed. Nutter also helped the patient re-enroll in the Marketplace to obtain insurance for other services not related to her cancer diagnosis. “She was so relieved that she can receive her treatment without any delay in care that she broke down in tears for me working with her and not giving up,” says Nutter.
Aimee Hoch, LSW, is an oncology financial navigator at Grand View Health in Sellersville, Pa. She is also an ACCC Financial Advocacy Network Advisory Committee member and Voice Task Force member. Before becoming a financial navigator, Hoch was a social worker for 14 years at Grand View Health, a small community hospital about 45-minutes outside Philadelphia. While in this role, she noticed an increase in patients seeking help with accessing and affording their cancer treatment.
Hoch discovered through her own research that establishing a financial navigation program at her cancer program would be key in meeting patients’ long-term needs. But she also knew that advocating for this expansion to her leadership would require diligent work. Hoch shared with her cancer program and leadership patient stories, her day-to-day experiences, and metrics to prove that a dedicated financial navigation program could meet this patient need. In just a year and a half of advocating, Hoch established the financial navigation program at Grand View Health and became its first financial navigator—a part-time role that grew into a full-time position. She is no longer placing a band-aid on patients’ financial needs to ensure treatment for one day. Instead, she helps patients become financially healthy, so they can receive treatment for their entire cancer journey. “Patients are able to participate in their healing and recovery more. And they don’t have to worry about their finances,” she says.
One of Hoch’s recent patients was receiving treatment for lung cancer when she suddenly lost her job and insurance coverage due to the pandemic. This patient was the sole provider of the family and was facing multiple other stressors in her life. She was concerned that she wouldn’t be able to continue her treatment. Once made aware of the patient’s situation, Hoch acted. She secured a foundation fund to cover the costs of the patient’s premium for COBRA coverage and applied for the manufacturer's free medication program on behalf of the patient. The patient qualified for both programs and could receive treatment without worry of cost. As 2021 approached, the patient’s COBRA premiums would nearly double, and Hoch knew she would have to identify a more sustainable and affordable solution. Hoch helped the patient pick and secured an affordable Marketplace plan. Hoch also noticed the foundation fund previously used was available for 2021 and applied on behalf of the patient. On top of insurance premium assistance, the patient also qualified for the manufacturer’s co-pay card program. For the rest of 2021, the patient will no longer have to worry about her insurance premium or co-pay costs associated with her cancer treatment.