Self-Pay Revenue Management

6 min read

True Costs of Cancer-Compassion

November 17, 2015 - 9:43 PM

Approximately 1 in 2 men and 1 in 3 women has a lifetime risk of developing cancer. The American Cancer Society reports that approximately 1,658,370 new cancer cases are expected to be diagnosed in 2015. Despite the advances in detection and treatment, 1,620 people die of the disease every day in the US.

Why does a billing and collections company care about cancer statistics? Firstly, because everyone should care about cancer. Secondly, because the current well-meaning billing policies of cancer treatment centers are doing more harm than good, and we believe that needs to be changed.

Financial wasteland of a cancer diagnosis

Just imagine for a moment, the terror of hearing a doctor say “You have cancer.” In a split second, everything you assumed about your health, work-life, family and finances is shattered. You don’t know which way to turn, you don’t know what questions to ask and worst of all, you don’t know what you don’t know.

Set against that backdrop, your immediate future is one of frightening medical procedures and ruining medical costs. Many cancer centers expect that you will also have the wherewithal to realize you need financial advice, both for paying medical costs and keeping your personal life afloat. Our guess is that if you are faced with a life threatening diagnosis, the last thing on your mind is the groceries- you want the best treatment you can find, and you want it now.

It’s not that medical professionals want to make things more difficult for their patients- quite the opposite. We have found that cancer treatment centers err on the side of not delivering bills to patients on a timely manner. They tend to be compassionate to a fault, and that means they hold back on discussing the finances of cancer. As a result, bills are sent later in the treatment cycle, patients may be too sick, or too deep in debt to figure out how to pay them, and the whole mess ends up in radiology bad debt collections.

Compassionate billing means timely billing

We believe there is a better way. Compassionate billing doesn’t mean not billing at all, rather, it means educating patients, setting up payment plans and staying in touch. It means ensuring that cancer patients meet with a financial counselor or social worker who can help them understand what the costs of their specific cancer care are apt to be, and how that can be paid. It means that a payment plan is set up at the outset, just after diagnosis, and that the financial planners check in with the patient during, and after their treatment. If a patient enters a financial wasteland because of his/her cancer treatment, no one is going to get paid- and that is not the goal.

Exactly how much are we talking about?

You had better sit down. According to the American Society of Clinical Oncology (ASCO),  in the last decade the average monthly cost of cancer treatment “has more than doubled to $10,000.  A handful of treatments now cost more than $100,000 annually per patient.”  As cancer treatment advances, therapies move toward the use of multiple treatment agents, which of course costs even more. The ASCO says that strategies are being pursued to control these costs, most of them administrative, and many get in the way of treatment, i.e. delays for preauthorization, and targeted treatments (which can be more expensive, see bullet 3 below).

Looking at just the cost of cancer drugs, and not the benefit, will make your hair stand on end. The ASCO reports:

Cancer drug costs are steadily increasing over time, with some approaching nearly $40,000 per patient, per month in 2014 dollars.

  1. Cancer drugs represent 8 of the 10 most expensive drugs reimbursed by Medicare.
  2. Targeted drugs are especially expensive, reaching up to $270,000 annually per patient.
  3. In 2012, spending on specialty pharmaceuticals reached $87 billion in the United States and is on track to account for 50 percent of drug spending by 2019.
  4. Spending on oral oncology drugs is also growing with a 37 percent increase in average quarterly spending over five years, from $940 million in 2006 to $1.4 billion in 2011 (in 2012 dollars).

Keeping life afloat while cancer rocks the boat  

Cancer has a way of interrupting life, making it much more difficult on a daily basis. Not only must the cancer patient endure expensive treatment, s/he must find a way to keep daily life moving forward. As explains, there are many hidden costs of daily living that “increase due to a long-term illness and its treatment.” While the patient may have to work less, or not at all, expenses incurred because of the cancer climb steadily.

  • Gas and parking while traveling to treatment
  • Hotel or lodging costs if treatment is far from home
  • Additional child care expenses for treatment days
  • Co-pays for doctor’s appointments, lab fees
  • Additional medications to manage side effects of treatment.
  • Expenses to care for your family during cancer treatment, such as household help, childcare, elder care, and coping support.
  • Nursing care at a facility or a home health aide

If a patient is struggling to keep his or her life afloat, the medical bills are going to fall to the end of the list of financial priorities.

The growing trash pile of medical bills

The issue of paying medical bills is not pretty picture. In fact, many bills are ending up in the trash, and the pile is growing. According to Forbes: “The fact is that more patients than ever are not paying their medical bills and that trend is expected to grow. While it is true that under healthcare reform more consumers will be covered by insurance, at the same time more patients are either unable or outright refusing to pay their copays, deductibles, co-insurance, and other legally contracted financial responsibilities.”

An informed patient is one who is more apt to make an effort to pay his or her medical bills. Look at it this way; finances of any type create stress. If a patient is very ill, and facing massive medical bills, the stress increases exponentially. Educating the patient about treatment costs, payment plans and exploring charitable agencies that can help will reduce that stress, and allow the patient to concentrate on treatment and recovery.

The answer: create informed patients

Don’t be afraid of informed patients. They are more apt to pay, (or to at least try to pay), their medical bills. The old saying “He who hesitates is lost,” holds true here. By the time cancer-related medical bills go to collections, the patients may be seriously in debt – or worse- bankrupt. You can’t dun a patient who is in financial ruin. They can’t pay your bill.

Creating informed patients means working with them to implement a payment plan that makes sense to everyone.

  • Working together creates understanding and a level of trust.
  • It is your best insurance of receiving some type of ongoing payment.
  • It removes the patient’s fear of bringing up the subject of payment.
  • It creates an ongoing dialogue, and access between you and the patient.

Cancer is ugly. The effort to get paid doesn’t have to be.

At Emerald we provide a service that takes the patient pay portion from Day 1.  Working to send timely statements and making calls to assure the patient understands the bill and is aware of the payment options they have.  We file Probate electronically and in most cases without the next of kin having to take the steps to add or rehash their unfortunate event. We take the “collection” part out and replace with information.

-Audrey Cooper

The state of cancer care in America- 2015, American Society of Clinical Oncology Cancer facts and figures.

American Cancer Society, Forbes:

Written by Acooper32

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