Delivery of Financial Navigation Services Within National Cancer Institute-Designated Cancer Centers

Background Cancer Centers have a responsibility to help patients manage the costs of their cancer treatment. This article describes the availability of financial navigation services within the National Cancer Institute (NCI)-Designated Cancer Centers. Methods Data were obtained from the NCI Survey of Financial Navigation Services and Research, an online survey administered to NCI-Designated Cancer Centers from July to September 2019. Of the 62 eligible Centers, 57 completed all or most of the survey, for a response rate of 90.5%. Results Nearly all Cancer Centers reported providing help with applications for pharmaceutical assistance programs and medical discounts (96.5%), health insurance coverage (91.2%), assistance with non-medical costs (96.5%), and help understanding medical bills and out-of-pocket costs (85.9%). Although other services were common, in some cases they were only available to certain patients. These services included direct financial assistance with medical and non-medical costs and referrals to outside organizations for financial assistance. The least common services included medical debt management (63.2%), detailed discussions about the cost of treatment (54.4%), and guidance about legal protections (50.1%). Providing treatment cost transparency to patients was reported as a common challenge: 71.9% of Centers agreed or strongly agreed that it is difficult to determine how much a cancer patient’s treatment will cost and 70.2% of oncologists are reluctant to discuss financial issues with patients. Conclusions Cancer Centers provide many financial services and resources. However, there remains a need to build additional capacity to deliver comprehensive financial navigation services and to understand the extent to which patients are referred and helped by these services.