Financial Toxicity: A Barrier to Achieving Health Equity in Cancer Care

Tucker-Seeley, Reginald

doi:10.1016/j.jacr.2022.12.004

Cited by 4 publications

(2 citation statements)

References 17 publications

(17 reference statements)

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“…2 Cancer care expenses are on a consistent upward trajectory in the United States, projected to surge by over 30% from 2015 to 2030, reaching approximately $246 billion, creating a significant burden for both health care payers and patients. 3 As treatment costs rise and cost-sharing increases, families face substantial financial burdens, posing challenges in managing out-of-pocket expenses within the cancer care system, with many families ill-equipped to handle these escalating costs. 4 , 5 This financial strain has given rise to the concept of financial toxicity.…”

Section: Introductionmentioning

confidence: 99%

The Affordable Care Act and income-based disparities in health care coverage and spending among nonelderly adults with cancer

Olateju,

Shen,

Thornton

2024

Health Affairs Scholar

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The Affordable Care Act (ACA) significantly reduced uninsured individuals and improved financial protection; however, escalating cancer treatment has led to substantial out-of-pocket expenses, causing severe financial and mental health distress for individuals with cancer. Mixed evidence on the ACA's ongoing impact highlights the necessity of assessing health spending changes across income groups for informed policy interventions. In our nationally representative survey evaluating the early-and-long-term effects of the ACA on non-elderly adult cancer patients, we categorized individuals-based income subgroups defined by the ACA for eligibility. We found that ACA implementation increased insurance coverage, particularly evident post-2 years. Early post-ACA, there were declines in out-of-pocket spending for the lowest and low-income groups by 26.52% and 38.31% respectively, persisting long-term only for the lowest-income group. High-income groups experienced continuously increased out-of-pocket and premium spending by 25.39% and 34.28% respectively, with a notable 122% increase in the risk of high-burden spending. This study provides robust evidence of income-based disparities in financial burden for cancer care, emphasizing the need for healthcare policies promoting equitable care and addressing spending disparities across income brackets.

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Section: Introductionmentioning

confidence: 99%

The Affordable Care Act and income-based disparities in health care coverage and spending among nonelderly adults with cancer

Olateju,

Shen,

Thornton

2024

Health Affairs Scholar

View full text Add to dashboard Cite

show abstract

“…Furthermore, the burdens of cost-related care interference are not experienced equally, with a higher prevalence among uninsured or publicly insured patients ( al Rowas et al, 2017 ; Amin et al, 2021 ), patients of color ( Weaver et al, 2010 ; Wheeler et al, 2018 ), and low-income patients ( Amin et al, 2021 ). As such, understanding and addressing patient financial hardship, and how such hardship influences access to care ( Levesque et al, 2013 ), is a necessary step toward promoting equitable cancer care delivery ( Tucker-Seeley, 2023 ).…”

Section: Introductionmentioning

confidence: 99%

Facing financial barriers to healthcare: patient-informed adaptation of a conceptual framework for adults with a history of cancer

et al. 2023

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BackgroundCancer-related financial hardship is associated with negative clinical outcomes, which may be partially explained by cost-related delayed or forgone care in response to financial barriers. We sought to understand patient experiences facing financial barriers to medical care following a cancer diagnosis.MethodsWe conducted virtual, semi-structured interviews in Fall 2022 with 20 adults with a history of cancer who had experienced cancer-related financial hardship in the prior year. We used template analysis within a pragmatic paradigm, combining constructivist and critical realist theoretical perspectives, to analyze interview transcripts and adapt an existing conceptual framework of financial barriers to care.ResultsThe majority of interviewees identified as women (70%), non-Hispanic white (60%), and reported an annual household income of <$48,000 (60%). As interviewees sought to overcome financial barriers, they described substantial frustration at the limitations and complexities of United States health and social care systems, resulting in a reliance on a fragmented, uncertain resource landscape. The administrative burden resulting from bureaucratic systems and the advocacy responsibilities required to navigate them ultimately fell on interviewees and their caregivers. Thus, participants described their ability to overcome financial barriers as being influenced by individual and interpersonal factors, such as social support, comfort asking for help, time, prior experience navigating resources, and physical and mental health. However, participants noted health system organizational factors, such as whether all new patients proactively met with a social worker or financial navigator, as having the potential to lessen the administrative and financial burden experienced.ConclusionWe present an adapted conceptual framework outlining multi-level factors influencing patient experiences coping with financial barriers to medical care. In addition to influencing whether a patient ultimately delays or forgoes care due to cost, financial barriers also have the potential to independently affect patient mental, physical, and financial health.

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Introduction to Financial Toxicity and the Growing Affordability Crisis

Chino

Sadigh²

2023

Journal of the American College of Radiology

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Financial Toxicity: A Barrier to Achieving Health Equity in Cancer Care

Cited by 4 publications

References 17 publications

The Affordable Care Act and income-based disparities in health care coverage and spending among nonelderly adults with cancer

The Affordable Care Act and income-based disparities in health care coverage and spending among nonelderly adults with cancer

Facing financial barriers to healthcare: patient-informed adaptation of a conceptual framework for adults with a history of cancer

Introduction to Financial Toxicity and the Growing Affordability Crisis

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