October 09, 2019
2 min read

Cleveland Clinic Cancer Institute outlines approach to address patient financial burden

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Kimberly Bell, BSN
Kimberly Bell

A white paper issued by Cleveland Clinic Cancer Institute describes the organization’s patient-focused approach to addressing issues related to financial toxicity.

The document, titled “Patient financial burden: Considerations for oncology care and access,” provides detailed information on a series of internal operational enhancements to reduce financial and other barriers to care.

HemOnc Today spoke with Kimberly Bell, BSN, administrator for Cleveland Clinic Taussig Cancer Institute, about why patient financial burden has been increasing in recent years, the key things an institution can do to help patients navigate financial issues, and challenges that remain.

Question: Can you describe the purpose of this white paper ?

Answer: For the past 15 to 20 years, we have been working on trying to manage financial concerns for patients with cancer, and we have taken many steps to get here. We have accomplished some of what we set out to do and thought it was time to publish this white paper because we believe it can help other cancer centers support their patients.

Q: Why has patient financial burden been increasing in recent years?

A: Due to the rising costs of health care, the changing payer structure and insurance benefits have driven providers to find ways to help patients receive the care they need without having to spend their life savings. Our institute’s overarching program to lessen the burden for patients is not just focused on what is coming out of patients’ pockets in copay deductions — it is also about removing barriers to care, including providing transportation so patients can get to their appointments, for example. It is important that we support the whole patient.

Q: What are the key things that institutions can do to navigate these issues today ?

A: Institutions must first identify the issue impacting their patients, then create a structured initiative to address it. We chose to publish the effects of financial navigators, but there are many additional things institutions can do. Addressing the financial burden is a great place to start because it creates immediate relief for patients. The third step is to create standards in information technology (IT) systems that identify all patients being treated to help make the navigation process efficient. Hiring the right people as financial navigators also is important. At Cleveland Clinic, we tend to hire people who have worked within revenue cycle management because they are familiar with our financial system and aware of the payers’ and patients’ out-of-pocket concerns. The financial navigators must also possess excellent customer service skills.


Q: What are some of the challenges that remain?

A: We are still working through perfecting IT and make it more efficient. It is complicated because we need a system to manage volume, financial impact and patient statistics. Our next step is to examine how our program can impact measures and patients across the Cleveland Clinic system — not just our cancer institute. This step may involve designing a patient survey or other tool to get their feedback.

Q: Is there anything else that you would like to mention?

A: Our white paper focused on the rising costs of health care and payer changes, but our efforts are not limited to adding financial navigators. We also are looking at ways we can incorporate other resources to support our patients with cancer. – by Jennifer Southall


Bell K, et al. Patient financial burden: Considerations for oncology care and access. Available at: www.managedcaremag.com/sites/default/files/downloads/patient-financial-burden_cleveland-clinic_wp.pdf. Accessed Oct. 7, 2019.

For more information:

Kimberly Bell, BSN, can be reached at Cleveland Clinic, 9500 Euclid Ave., JJN4-01, Cleveland, OH 44195.

Disclosure: Bell reports no relevant financial disclosures. Genentech supported the white paper.