For many people with serious medical conditions and high out-of-pocket cost responsibilities, the financial burden of care can be just as damaging as their illnesses. High care costs can cause patients to feel stressed and anxious, impacting their overall well-being and ability to get better. According to Dr. Peter Ubel, professor of business, public policy and medicine at Duke University, a lack of price transparency for conditions that require expensive treatments, such as cancer, often results in “financial toxicity,” or when high medical bills cause patients stress and anxiety about their ability to pay for care to the point where they neglect their basic needs. Cost estimations and patient friendly billing, as well as speaking to patients about alternative care, are the best ways to protect patients against financial toxicity.
Financial toxicity affects critical care patients
Patient health and satisfaction with care can greatly suffer from financial toxicity, Dr. Ubel told the ASCO Post, and some of the patients most in need of care are often the ones who feel the negative effects of high care costs. Even if providers are unaware of the true costs of care, or advise patients to focus on their health rather than their finances, skyrocketing medical bills can end up causing patients to miss important treatments or stop taking their medications.
ASCO Post reported a recent study from researchers at the Center for Learning Health Care, the Duke Clinical Research Institute and the Duke Cancer Institute found 24 percent of cancer patients held off or neglected to fill their prescriptions to save money, and 20 percent took less medication than had been prescribed. In fact, the study found nearly half (46 percent) limited their food and clothing spending because of their medical payments.
According to the American Cancer Society, cost is often a factor in why patients stop their treatments early, and why the trend of cancer patients skipping tests and care is a growing concern within the medical community. When one considers the numerous treatments and tests cancer patients have to undergo and the prevalence of high-deductible plans on the market, it might not be a surprise that so many patients try to reduce their medical costs any way they can.
For example, Dr. Ubel says out-of-pocket expenses for breast cancer treatment can reach as high as $55,000, which is more than many people’s yearly earnings, the Robert Wood Johnson Foundation reported. Janet, a 67-year-old woman with metastatic breast cancer, told the Oncology Journal that not only was she burdened with a life-threatening illness but life-altering out-of-pocket expenses as well. With Dr. Ubel and his colleagues reporting more than 30 percent of insured individuals over the age of 65 feel the negative effects of high medical payments, the issue of financial toxicity may become more common.
Hospitals need to provide cost estimations
Yet avoiding care to prevent high medical payments doesn’t help patients get well, and it doesn’t improve their satisfaction with their providers either. Dr. Ubel has hit on the issue multiple times, such as in an article for The New York Times and during talks at medical schools, according to the ASCO Post. Dr. Ubel recently noted that while providers aren’t trained to be financial counselors, physicians must be able to provide patients with cost estimations to avoid patients from experiencing financial toxicity.
“Patients experience unnecessary financial distress when physicians do not inform them of alternative treatments that are less expensive but equally or nearly as effective,” Dr. Ubel and colleagues wrote in The New England Journal of Medicine, the ASCO Post reported. “Many women reported discussing treatment-related costs with their physicians only after they had begun to experience financial distress.”
Not all physicians have the tools necessary to provide patients with cheaper care alternatives. It’s imperative that hospitals offer physicians the resources they need to speak to patients about care costs. Tools like cost estimations can help patients understand their financial responsibilities for each treatment, test and prescription, which aids physicians in making sure patients feel financially comfortable with their care. No patient – whether suffering from a critical condition or not – should feel as if they cannot receive the care they require because they were not prepared for the costs. By providing patients with patient friendly billing and cost estimations, hospitals can ensure they collect timely patient payments and have high patient satisfaction at the same time.