OHC Financial Assistance for Cancer Patients Grows by 30%
OHC has ramped up its efforts to collect assistance money for cancer patients. In simple terms, the assistance money OHC collects are “funds that otherwise the patients would have to had paid,” according to Jessica Spinks, OHC financial services manager.
So far this year, OHC has collected $558,940.20 in assistance money, an increase of $127,549.60 since 2012. This nearly 30 percent increase in funds collected is in part due to additions in the patient and account services team. It is also reflective of the state of the healthcare market today.
Assistance money comes from various foundations (or charities) that assist qualifying patients to help cover their out-of-pocket medical costs. It also comes from pharmaceutical companies that assist qualifying patients with their out-of-pocket drug costs.
The amount a patient is eligible for depends on a number of things, including diagnosis, drugs taken, and income. OHC’s financial navigators can guide patients through the process of applying for assistance.
In order to receive the funds, patients must go through their insurance companies first to receive an explanation of benefits (or EOB). The EOB determines the patient’s responsibility, which is submitted to the foundation or co-pay assistance program for reimbursement.
According to OHC, if a patient has commercial insurance, meaning they’re not on Medicare or Medicaid, the pharmaceutical company that provides the drugs they receive may provide copay assistance. In that way, they’re helping remove any barriers to a patient getting that drug.
If a patient has Medicare, they do not qualify for co-pay assistance. However, many foundations cater to patients who have a government-funded insurance plan. Foundations are often diagnosis-specific. For example, a foundation whose emphasis is breast cancer may provide assistance only to patients who have been diagnosed with that type of cancer. Patients should contact their financial navigators to determine what foundational assistance to apply for.
OHC hasn’t been afraid to put the necessary resources into collecting more funds for its patients. It has hired seven additional financial navigators in the past three years, making collecting funds easier. OHC also utilizes more foundations and copay assistance programs than in previous years. According to Jessica, they have developed a structure around the program, which has contributed to its success.
Due to the nature of today’s healthcare market, cancer and blood disorder patients now have higher deductibles, higher out-of-pocket costs, and higher co-pays than ever before.
A 2011 study by Duke University showed that the average cancer patient in the United States pays over $8,500 a year in out-of-pocket medical expenses not covered by insurance. Other studies have shown that bankruptcy rates are nearly double among cancer patients one year after diagnosis than they are for the general population.
So it’s obvious that there is a tremendous need for assistance. Ironically, since patients owe more, OHC is also able to collect more. And that’s what we’re doing. “If you look at other oncology practices,” notes Jessica, “I really think we’re ahead of the curve on some of the things we’re doing and how we’re proactively helping patients with their cost of treatment.”
The OHC financial assistance program embodies the ‘Patients First’ motto that OHC embraces. It is the financial navigators’ goal to ease that financial burden so patients can concentrate solely on treatment.
According to Jessica, “We do everything we can to help them be comfortable and confident in their financial arrangements with us, because then they can focus on their health and getting better as opposed to worrying about their medical bills.”
Besides an overall decrease in patients’ out-of-pocket costs, Jessica has observed an overwhelming amount of gratitude from patients and their families. Our physicians also reap the benefits that OHC financial navigators provide, as they can focus entirely on their patients’ care.
Overall, the funds collected by OHC help ease our patients’ financial stress so they and their medical team can focus on their treatment. Adds Jessica, “While all oncology practices treat their patients clinically, OHC goes a step further to address their financial needs as well.”