Effectiveness of Out-of-Pocket Cost COMmunication and Financial Navigation (CostCOM) in Cancer Patients

自付费用沟通和财务导航 (CostCOM) 对癌症患者的有效性

• 批准号: 10498114
• 负责人: Gelareh Sadigh
• 金额: $ 65.27万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-04 至 2027-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10498114
• 关键词: Address; Advocate; Cancer Patient; Caring; Client satisfaction; Communication; Community Clinical Oncology Program; Complement; Complex; Conduct Clinical Trials; Counseling; Diagnosis; Disclosure; Dose; Drug Prescriptions; Education; Effectiveness; Enrollment; Ethnic Origin; Financial Hardship; Financial Support; Foundations; Geography; Goals; Health; Health system; Hospitals; Hour; Income; Insurance Benefits; Insurance Coverage; Intervention; Interview; Learning; Link; Malignant Neoplasms; Measures; Medical; Newly Diagnosed; Nonmetastatic; Office Visits; Outcome; Pamphlets; Patient Care; Patient Outcomes Assessments; Patient Self-Report; Patients; Perception; Population; Preparation; Price; Professional counselor; Program Sustainability; Provider; Qualitative Methods; Quality of life; Race; Randomized, Controlled Trials; Recommendation; Reporting; Research; Resources; Risk; Services; Site; Solid Neoplasm; Surveys; System; Testing; Time; Treatment Cost; United States; United States Centers for Medicare and Medicaid Services; arm; cancer care; cancer diagnosis; cancer therapy; care costs; care delivery; comparative cost effectiveness; cost; cost effectiveness; effectiveness evaluation; effectiveness testing; enhanced care; experience; follow up assessment; health care service utilization; improved; innovation; interest; multidisciplinary; multiple sclerosis patient; participant enrollment; patient engagement; patient population; personalized intervention; personalized medicine; primary endpoint; primary outcome; process evaluation; programs; recruit; satisfaction; shared decision making; socioeconomics; telecoaching; telephone session; therapy design; tool; treatment as usual; usual care arm; video session

PROJECT SUMMARY High out-of-pocket costs (OOPC) of cancer treatment and lost income result in financial hardship. There is compelling evidence that OOPC communication complemented by financial navigation and counseling will decrease financial hardship by enabling cancer patients to anticipate and accommodate treatment costs and proactively seek financial assistance. Importantly, this intervention aligns with the Centers for Medicare and Medicaid Services (CMS) price transparency mandate. We will evaluate the effectiveness of an innovative personalized intervention designed to improve cost-related cancer care non-adherence by conducting a randomized controlled trial of OOP cost communication and financial navigation (CostCOM) vs. enhanced usual care (EUC) at NCI Community Oncology Research Program (NCORP) practices. Our multidisciplinary team has experience with all facets of the proposed intervention including conducting clinical trials at NCORP practices. CostCOM comprises four 1-hour counseling sessions to impart: (1) OOPC communication, individualized, patient-specific education of the anticipated OOPC using a price estimator tool; (2) Financial navigation, real-time professional guidance to identify financial assistance programs that will alleviate costs of care and discuss information to improve insurance coverage; and (3) Financial counseling to address the range of patients’ financial concerns and enroll patients in financial assistance programs. We will recruit 720 patients with newly diagnosed solid tumors (1:1 non-metastatic vs. metastatic) who plan to receive anticancer therapy at one of the participating NCORP practices. CostCOM arm patients will participate in four phone or video sessions with a remote financial counselor at baseline, 3, 6, and 12 months, with all three components of CostCOM delivered at each session. At enrollment, EUC arm patients will receive usual care enhanced by providing an educational brochure describing services and contact information of the Patient Advocate Foundation (PAF), a national non-profit financial navigation organization. Patients will complete surveys at baseline, 3, 6, and 12 months after enrollment. Our goals are to (1) compare the effectiveness of CostCOM vs. EUC at 12 months on patient-reported cost-related cancer care nonadherence, defined as any self-reported incident of delay, forgo, stop or change in cancer care due to cost concerns, as well as (2) patient-reported material financial hardship, financial worry, and quality of life; and (3) conduct a process evaluation to examine practice providers and CostCOM arm patients’ satisfaction with the intervention and their perceptions of barriers and facilitators to CostCOM delivery (for providers) or receipt (for patients). A successful CostCOM is a scalable and financially sustainable program that can be disseminated across systems, conditions, and populations and improve cancer care delivery, patients’ experience, and health outcomes.

项目摘要 癌症治疗和收入损失的高自付成本（OOPC）导致经济困难。有 令人信服的证据表明，通过财务导航和咨询完成的OOPC沟通将 通过使癌症患者能够预期和住宿治疗费用以及 主动寻求财政援助。重要的是，这种干预措施与Medicare中心和 医疗补助服务（CMS）价格透明度授权。我们将评估创新的有效性 个性化干预措施，旨在通过进行与成本相关的癌症护理不遵守 OOP成本通信和财务导航（CostCom）与随机对照试验与VS。 NCI社区肿瘤研究计划（NCORP）实践增强了常规护理（EUC）。我们的 多学科团队在拟议干预的所有方面都有经验，包括进行临床 NCORP实践的试验。 Costcom包括四个1小时的咨询会议：（1）OOPC 使用价格估计器工具对预期的OOPC进行沟通，个性化的，特定于患者的教育； （2）财务导航，实时专业指导，以确定财务援助计划 减轻护理和讨论信息以提高保险范围； （3）财务咨询 解决患者财务问题的范围，并注册患者参加财务援助计划。我们将 计划接受的720例新诊断的实体瘤患者（1：1非转移性与转移性） 参与的NCORP实践之一。 Costcom Arm患者将参加四个 在基线，3、6和12个月与远程财务顾问的电话或视频会议，这三个 每个会话都交付了CostCom的组件。入学时，EUC ARM患者将获得常规护理 通过提供描述患者服务和联系信息的教育手册来增强 国家非营利金融导航组织倡导者基金会（PAF）。患者将完成 入学后的基线3、6和12个月的调查。我们的目标是（1）比较 Costcom vs.在12个月的患者报告的与成本相关的癌症护理不依从性的情况下，定义为任何 由于成本问题而引起的延迟，忘记，停止或改变癌症护理的自我报告事件，以及（2） 患者报告的物质财务困难，财务忧虑和生活质量； （3）进行过程 评估以检查实践提供者和Costcom ARM患者对干预和 他们对障碍和促进者对CostCom交付（用于提供者）或收据（适用于患者）的看法。一个 成功的Costcom是一项可扩展且在财务上可持续的计划，可以在各个方面传播 系统，条件和人群，并改善癌症护理提供，患者的经验和健康 结果。