Financial Assistance Processes and Mechanisms in Rural and Nonrural Oncology Care Settings

Area of Science:

• Oncology
• Health Services Research
• Health Economics

Background:

• Cancer patients face significant financial hardship.
• Financial navigation (FN) is an evidence-based intervention to address these financial needs.
• Understanding current processes is crucial for implementing effective FN interventions.

Purpose of the Study:

• To describe existing processes and mechanisms connecting cancer patients to financial assistance.
• To compare financial assistance processes in rural and nonrural oncology practices.
• To identify facilitators and barriers in addressing patient financial needs.

Main Methods:

• Conducted semistructured interviews with 83 stakeholders across 10 oncology care sites (5 rural, 5 nonrural).
• Developed process maps for each site and analyzed stakeholder perspectives using thematic analysis.
• Synthesized themes and process maps across rural and nonrural sites.

Main Results:

• Identified six core elements in financial assistance processes: distress screening, referrals, resource connection, and pharmaceutical, insurance, and community/foundation resources.
• Found facilitators (open communication) and consistent barriers (staff resources, identifying needs, patient preparation, resource tracking) across sites, despite some process differences by rurality.
• Highlighted a need for systematic oncology financial navigation to equitably address patient and caregiver financial hardship.

Conclusions:

• Systematic implementation of oncology financial navigation is essential for equitable patient support.
• Findings inform the development of a multisite FN intervention with comprehensive screening and systematized intake/referrals.
• Addressing financial toxicity is a critical component of comprehensive cancer care.