Innovative Healthcare Financing, February 2018
Many patients in the United States struggle with out-of-pocket medical expenses. For patients with cancer, who are more than twice as likely as their peers to declare bankruptcy, the financial costs are particularly acute. In 2017 and early 2018, Tapestry Networks, in partnership with payers, pharmacy benefits managers, physicians, finance professionals, actuaries, and academics, launched the Innovative Healthcare Financing (IHF) initiative to address how financing vehicles could enable greater patient access to oncology treatments.
Earlier conversations with financial and healthcare professionals on financial approaches that could be applied within the US healthcare system to manage costs and expand patient access made clear that the respective groups did not speak a common language. Therefore, the IHF initiative began with an educational call series to create a shared baseline understanding among participants of the US healthcare system, its product and financial flows, and its complexities specific to oncology.
The effort culminated in a November 2017 working meeting that was co-hosted by Dana-Farber Cancer Institute and aimed to build on the education series and existing conceptual thinking in this area. The meeting’s scope was targeted. While recognizing that long-term sustainability of the healthcare system will require significant systemic changes, participants focused on brainstorming interim solutions to meet an immediate need: the rising costs of oncology treatments and resulting gaps in access.
The group addressed how complex financial tools could be used in two areas that are in particular need of attention:
Rising patient out-of-pocket costs
The budget impact of high-cost oncology treatments on institutional stakeholders: payers, pharmacy benefits managers, and others (e.g., pharmacies, providers) within the supply chain