Covid-19 has put a new spotlight on financial toxicity in health care. As people lose their jobs and insurance, they find it harder than ever to pay for the already costly cancer care necessary to save their lives. This is where financial navigators come into play: While navigators have always held an important role, Covid-19 has highlighted how navigators play a key role in ensuring patients can traverse the difficult and confusing road ahead—and ensure they keep coming to the hospital for treatment.

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America's growing uninsured population

Even before Covid-19 hit the United States, the country's uninsured rate was rising. According to the U.S. Census Bureau, the number of uninsured people rose by 2.34 million from 2016 to 2019, and the current epidemic and ensuing financial downturn have further exacerbated this issue. In fact, a survey of 1,200 cancer patients by the American Cancer Society Cancer Action Network found that 43% of respondents, or a family member living with them, had recently lost a job and their accompanying employer-sponsored health insurance. As people become uninsured and their ability to pay for their health care is compromised, important and life-saving care could fall by the wayside.

As a result, financial navigation and advocacy have become critical to many patients' well-being. Helping patients understand their bills, optimize their insurance, and find grants or other financial support ensures patients can continue undergoing treatment—particularly for oncology patients, whose treatments are often long and costly.

This is not news, and many cancer programs have been slowly building out their program. For example, Advisory Board's 2019 Trending in Cancer Care Survey found 43% of respondents were planning to add to or grow their financial advocacy programs in the next 12 months. However, 49% also said they were worried about the bandwidth of their programs and ensuring patient access. Given the increased financial strain on patients during the epidemic, financial navigation is more important than ever, and cancer centers need to quickly build out and strengthen their programs for the patients who desperately need it.

5 steps to build out your financial navigation program

To build out your financial navigation program during this particularly challenging time, your organization should:

1. Connect patients to financial navigation

   Few cancer programs have systematic processes in place to identify patients who need financial counseling. This responsibility is typically fragmented between registration staff, social workers, navigators, and clinicians. Overcome this hurdle by creating a standardized system that captures patients from multiple channels across the care continuum. Part of this effort can involve hardwiring financial checkpoints where patients are likely to experience financial distress.
   

    

2. Educate patients about their financial responsibility

   A critical first step of any financial navigation program is ensuring patients understand the basics of health insurance and their own insurance benefits. Prepare your patients by conducting a comprehensive benefits review and giving them out-of-pocket cost estimates.
   
   
   

    

3. Optimize patient coverage

   It's also vital to ensure patients have the best coverage possible. Screen patients for coverage eligibility, enhance partnerships with Medicaid Assistance Agencies that lack clinical expertise but improve acceptance rates, and coordinate the start of treatments with clinical teams to align with insurance coverage.
   
   
   

    

4. Maximize external assistance

   Even patients with relatively comprehensive health benefits may experience financial distress, so external sources of support are key. Screen for assistance program eligibility up front by automating the screening process and continuing to search for untapped sources of financial assistance instead of relying solely on tried-and-true resources, which might not be enough.
   
   
   

    

5. Improve patient collection

   While trying to collect the total amount owed by patients can be a poor use of resources, collecting just a small portion of patients' responsibility can have a big impact on the bottom line. To effectively do so, make sure to increase patient awareness of point-of-service collection, train staff for point-of-service collections, and build realistic payment plans.

Rising numbers of uninsured patients, coupled with the economic drain of the Covid-19 epidemic, has made financial navigation more important than ever to ensure cancer patients can receive necessary treatment—a need that will remain even after the epidemic is over. Get ahead of the curve by following the five outlined steps to create the most efficient financial navigation program you can.