Interdisciplinary Interventions to Address Medical Financial Hardship across the Healthcare System: A Social Ecological Approach

Medical-related financial hardship, or financial toxicity, occurs frequently among clients with chronic and acute healthcare conditions and is a key driver of inequities in access to care and disparities in treatment outcomes. The causes of financial toxicity are multi-factorial and multi-systemic and thus require solutions that reach across all levels of the healthcare system. This interdisciplinary roundtable will apply a healthcare-focused adaptation of the Social Ecological Model (SEM) to discuss collaborative interventions to prevent and mitigate financial toxicity, using the oncology setting as a case study.

The symposium organizer, a jointly appointed social work faculty member and cancer center researcher, will begin the session by orienting attendees to the structure and format of the roundtable, including the organizing SEM framework. The first speaker, a two-time cancer survivor and community-based patient advocate, will center the discussion by first sharing the biopsychosocial impact of financial toxicity on patients with cancer and then highlighting the importance of taking research beyond 'describing the problem' to creating and testing patient-centered interventions.

Then, applying the SEM, the roundtable will shift to focus on collaborative intervention research and real-world experiences at each level of the healthcare system: with patients and family/caregivers, in the community, among healthcare providers, in the hospital setting, and throughout state and national policy.

The second speaker, a clinical social worker and academic researcher, will present current interventions at the patient level, where financial toxicity is most acutely experienced. These interventions include social work-led efforts in patient financial navigation, direct financial assistance, and health insurance educational programming. Despite growing attention to financial toxicity in cancer care, few studies have investigated the experiences of caregivers and the family unit. As such, the third speaker, who is also a clinical social worker and academic researcher, will discuss financial hardship at the caregiver and family level and share ongoing efforts to characterize the role of interpersonal processes and intermediate factors for dyadic financial toxicity interventions.

The fourth speaker, an oncology social worker who serves as Vice President of Programs and Health Equity at Family Reach, a nonprofit organization that provides financial support to families facing cancer, will discuss the role of community-based advocacy organizations in financial toxicity program development and delivery. Finally, shifting to the hospital setting, the last speaker, a practicing radiation oncologist and health disparities researcher, will share research-based and real-world advances in financial toxicity screening and assistance referral patterns, including efforts to facilitate communication about financial toxicity between patients with cancer and their healthcare teams. She will also highlight policy interventions to improve affordability and promote value-based care, focusing on both state and national policy changes and efforts toward payment reform.

Following brief presentations from the speakers, the panel will engage in discussion, both among themselves and with the session attendees. The symposium organizer will moderate the discussion, with each panelist posing 1-2 questions to the audience to facilitate engagement.