Carol’s Wish: Reducing the Financial Burden of Cancer Care
People facing an unexpected cancer diagnosis may opt to delay or even forgo care due to the high cost of cancer treatment. Not seeking immediate cancer care can result in poorer outcomes, higher costs due to disease progression, and ultimately an increased risk of death. The Colorado Gynecologic Cancer Association initiative, Carol’s Wish, a financial navigation program for people with gynecologic cancer, helps under-resourced patients enroll in insurance plans and find ways to reduce out-of-pocket costs. Navigators also help patients connect with financial support services such as grants to help cover expenses such as travel and housing to access treatment.
Using Colorado All Payer Claims Database (CO APCD) data, the CIVHC evaluation team partnered with the Colorado Gynecologic Cancer Association to answer two key questions about participants who utilized their Carol’s Wish financial navigations services:
- Do Carol’s Wish services lower out-of-pocket costs for program participants?
- How does cost of care and access to care differ for Carol’s Wish participants?
Summary: To measure the program’s impact, CIVHC’s evaluation analysts used the CO APCD to compare the total health claim costs and member out-of-pocket spending in the six months following a gynecologic cancer diagnosis for program participants against a group of similar non-participants. By focusing on the six months after diagnosis, they limited the analysis to the highest-cost treatment period and avoided capturing expenses related to cancer resurgence.
Findings: Results indicated that the financial navigation services were effective at reducing patient out-of-pocket costs. Participants had significantly higher total health care spending than non-participants for all health care. Although participants also paid more out-of-pocket, their proportion of the total cost was lower than what their non-participant peers paid. These results suggest that the insurance optimization services of Carol’s Wish improved access to care by reducing the out-of-pocket cost of each visit. This finding helped quantify benefits reported by participants, many of whom shared with program staff that they can now access the care they need through these more affordable insurance plans.
Benefit to Colorado: Affordability should never be a barrier to accessing care and treatments, yet many patients struggle to afford care—even with insurance. As discussed in the Carol’s Wish Data to Drive Decisions Webinar, financial navigation programs help patients understand their options, access assistance, and reduce the economic stress of an unexpected diagnosis.
The results of this evaluation project show that financial assistance programs work, and help lay the foundation for more funding to support and expand Carol’s Wish services. It also makes the case to potentially initiate similar programs for other conditions statewide and nationally to support people with a cancer or other high-cost treatment diagnosis.
Additional Resources:
- Carol’s Wish Evaluation Project Webinar
- Carol’s Wish Evaluation Project Report
- PowerPoint Presentation of Findings
