Among a cohort of cancer patients and survivors, engaging in administrative tasks to estimate costs or pay for care was associated with an 18% increase in cost-related treatment delays or nonadherence, according to a new study by Assistant Professor Meredith Doherty of Penn’s School of Social Policy & Practice (SP2) and coauthors.
Navigating the U.S. health care system requires a complex set of communications between patients, health care providers, and insurance companies, said Dr. Doherty, senior author of the study. The burden of learning about the costs of care and fixing billing errors often falls to the patients, she explained.
“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.”
For their study, published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research, Dr. Doherty and colleagues used data from a cross-sectional survey performed by the nonprofit CancerCare. The survey polled cancer patients and survivors about their engagement in payment-related administrative tasks and their experience with cost-associated treatment delays or nonadherence.
After adjusting for age, race/ethnicity, education, and monthly out-of-pocket costs, participants who engaged in any administrative tasks were 18% more likely to experience any treatment delays or nonadherence than participants who did not engage in administrative tasks. Engagement in each additional task was independently associated with an increase in treatment delays or nonadherence.