A new tool to remove maintenance barriers

Funding for Cancer

Even with insurance, facing the cost of cancer treatment can be overwhelming. Insurance broker and cancer survivor Paul Barbary of Alton, featured in an earlier OSF Newsroom story about immunotherapy, said he’s thankful he has good insurance because the cost of each treatment his was $50,000. Barbary is healthy physically and financially, but not all cancer patients are in that situation.

Maria Rodriguez, a financial specialist at OSF HealthCare, remembers the fear her family felt when her father was diagnosed with cancer. There were concerns about his physical health but also his financial situation.

“My father is a cancer survivor and my goal is him. I sat on the other side, so I know how the patients feel – the devastation they go through, the anxiety, the panic… they go through it all. It is a human privilege to be able to help these patients.”

Fundraisers like Rodriguez not only help cancer patients, they also help patients with heart and chronic diseases, in addition to patients with expensive copays for orthopedic procedures. . And they have been able to help many patients in the past year through the use of TailorMed, a secure online financial assistance platform.

TailorMed says its platform accesses more than 6,000 resources for support including copay cards, foundations, free drugs, health drivers and government plans. Community drivers can include the cost of transportation, housing, child care and food assistance.

Rodriguez says TailorMed’s software is easy to use. Patients who have a care plan in their electronic medical record automatically come to the platform.

“We’re able to see the potential savings for that patient, what programs they can access, and they (TailorMed) give us an overview of the patient’s insurance coverage.”

Jacque Doerman, director of Patient Access at OSF HealthCare, said the funding fleet managers have with TailorMed has allowed them to do more to support patients. It has replaced Excel spreadsheets, calendar reminders and other powerful ways to keep track of available subsidies and prescription drug assistance.

“It took manual labor and automated it, making us more efficient, more efficient and getting more patients than we could before,” he says.

OSF HealthCare has been able to help nearly 350 patients with prescription and drug assistance in the past 12 months using the TailorMed platform. Doerman said that represents $367,000 in patient care.

“So, it would have ended where the patient has this much money. It would have ended up there and gone into bad debt. The dollars that came to OSF, that $367,000 would have been another kind of responsibility and burden that the patient would have had. ”

The National Institutes of Health says the cost of cancer care has risen from $57 billion in 2001 to $200 billion today, placing an unsustainable burden on patients, families, employers and payers. Stephanie Wilfong, who oversees financial management as director of Financial Services at OSF, says patients also often consider avoiding or leaving treatment because of concerns about going into debt.

“The first thing that comes to their mind is they’re going to spend their savings or retirement trying to pay for this and live and they choose not to,” Wilfong shares. “They choose not to end it, and they choose not to deal with the disease and that’s the saddest part (because) we can help them, and they don’t realize that we’re here to help, and they don’t no help. to make that decision at all.”

It can help those with insurance

The Kaiser Family Foundation (KFF) reports that those with health insurance and higher incomes are not immune to higher medical care costs, but Wilfong says many insured cancer patients , or another high-priced test if they don’t realize they can quickly go into debt.

“You might have good insurance, but it might be a drug that’s not covered or a procedure that’s not covered or we don’t know, we don’t know, so the first thing you should do is at least be and that conversation. because you never know what’s going to happen, and we’re here and we’re happy to help you.”

According to KFF, about 1 in 12 adults or 20 million people in the United States has medical debt. For cancer patients, prescription drugs make up about 20% of all costs according to President Biden cancer group. Drugs can change and prolong life, but they can be very expensive. That’s why TailorMed has a pharmacy module is being tested with financial navigators at OSF HealthCare Saint Anthony Medical Center in Rockford.

Registration procedures, for example for drug free programs, have also been completely streamlined or digitized, where possible, to reduce tedious form filling, faxing and publishing information. conditions. Wilfong says it helps coordinate refills and ensure eligible patients always get the medications they need, often for life-saving treatments.

“It prevents any overages so patients don’t have to wait and it’s nice to see how many applications are coming in, how much free medicine has been approved. It allows for better space across the board and better communication. between all groups.”

Rodriguez says TailorMed allows the pharmacy team to manage ordering, tracking and inventory of over-the-counter and other drugs. It also enables him to provide more help to people such as a patient who recently lost his job suddenly and was helped by Maria and TailorMed. His wife wrote a thank you note to the patient that read in part, “We are in his debt and truly appreciate his dedication and compassion during his time.” he isolated himself and struggled. We thank God for him and for the OSF staff. ”