The Massachusetts-based Foundation Medicine has joined forces with a health care consumer group with the intent of assisting in the sometimes onerous cost of providing cancer care. The alliance, known as FoundationOne CareLine, is between Foundation Medicine and the Virginia-based Patient Advocate Foundation (PAF). It is the expansion of a previous pilot program that began in late 2012. It offers case management services to uninsured and underinsured patients facing obstacles in identifying and obtaining specific therapies for their tumor types. PAF focuses on providing financial relief to consumers who need medical care, including coverage of copayments, assistance in navigating health insurer bureaucracy, and medical debt relief. “Rapid developments in genomics and the scientific understanding of cancer in recent years have fundamentally changed the way cancer can be treated, yet at times, the advances evidenced by new medical and scientific data have outpaced access to treatment,” said Deborah Morosini, M.D., Foundation’s vice president of clinical development. “Through this partnership with Patient Advocate Foundation, FoundationOne CareLine connects patients to case management resources that help them navigate the appropriate channels to secure treatments by leveraging peer-reviewed literature supporting their use.” Cancer care is among the most expensive forms of health care delivery in […]
The Massachusetts-based Foundation Medicine has joined forces with a health care consumer group with the intent of assisting in the sometimes onerous cost of providing cancer care.
The alliance, known as FoundationOne CareLine, is between Foundation Medicine and the Virginia-based Patient Advocate Foundation (PAF). It is the expansion of a previous pilot program that began in late 2012. It offers case management services to uninsured and underinsured patients facing obstacles in identifying and obtaining specific therapies for their tumor types.
PAF focuses on providing financial relief to consumers who need medical care, including coverage of copayments, assistance in navigating health insurer bureaucracy, and medical debt relief.
“Rapid developments in genomics and the scientific understanding of cancer in recent years have fundamentally changed the way cancer can be treated, yet at times, the advances evidenced by new medical and scientific data have outpaced access to treatment,” said Deborah Morosini, M.D., Foundation’s vice president of clinical development. “Through this partnership with Patient Advocate Foundation, FoundationOne CareLine connects patients to case management resources that help them navigate the appropriate channels to secure treatments by leveraging peer-reviewed literature supporting their use.”
Cancer care is among the most expensive forms of health care delivery in the United States, costing about $125 billion annually. That number is projected to reach $175 billion by the end of the decade. At the same time, most Americans are experiencing dramatically increasing out-of-pocket costs, even when they have insurance coverage. Some covered treatments leave patients with bills of $5,000 or more. Meanwhile, a genomic assay to determine the makeup of a tumor can cost $3,000 or more.
The caseworkers for Foudation and the PAF are trained as either nurses or social workers, with a background in insurance coding and billing. Foundation spokesperson Dan Budwick said they will help determine whether individuals are eligible for insurance coverage for FoundationOne’s tests and assist in appeals involving coverage, enrollment in clinical trials, and obtaining discounts or compassionate use waivers for pharmaceuticals.
Takeaway: Advances in personalized molecular medicine often do not take into consideration the often high costs of such care.
