Bottom Line: Engaging in administrative tasks to estimate costs or pay for care among a cohort of cancer patients and survivors was associated with an 18% increase in cost-related treatment delays or nonadherence.

Journal in Which the Study was Published: Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research (AACR)

Author: Meredith Doherty, PhD, LCSW, an assistant professor at the University of Pennsylvania School of Social Policy & Practice (SP2)
Background: Navigating the U.S. health care system requires a complex set of communications between patients, health care providers, and insurance companies, Doherty said. She explained that the burden of learning about the costs of care and fixing billing errors often falls to the patients.

“It’s fairly unique to our U.S. health care system for the consumer to be responsible for acquiring the knowledge and skills needed to effectively use those goods or services and to ensure they’re of high quality,” Doherty said. “In the United States, health care is largely treated as a consumer product, so the onus is on the consumer.”

After years of hearing anecdotal evidence about patients’ frustration with the administrative complexities of the health care system, Doherty came across a study showing that U.S. health care users felt that administrative burdens significantly affected their care. Doherty sought to explore this phenomenon among cancer patients and further quantify the relationship between administrative tasks and treatment delays or nonadherence.

How the Study was Conducted: Doherty and colleagues used data from a cross-sectional survey performed by the nonprofit CancerCare that polled cancer patients and survivors about their engagement in payment-related administrative tasks and their experience with cost-associated treatment delays or nonadherence. Participants were asked if they never, rarely, sometimes, often, or always participated in the following activities during their cancer care:

Administrative burdens
Estimated the out-of-pocket costs before agreeing to treatment
Appealed a denial of benefits from the insurance company
Found out the out-of-pocket costs before filling a prescription
Asked insurance company for help understanding coverage
Found out the out-of-pocket cost before getting a lab test or scan
Treatment delay or nonadherence behaviors
Postponed or skipped doctor’s appointments
Postponed or skipped follow-up testing

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