Policy Brief: The Measurable Impact of MFA Programs in Cancer Care and Beyond
Policy Brief: The Measurable Impact of MFA Programs in Cancer Care and Beyond
In a new policy brief, SHP's Alyce Adams and her colleague, Mateen Ghassemi, address financial toxicity in cancer care through Medical Financial Assistance (MFA) Policy.
Cancer is the second-leading cause of death in the United States—and the high treatment costs and associated expenses contribute to cancer being the leading cause of medical-induced bankruptcy among patients and caregivers.
This “financial toxicity” can also be fatal: cancer patients who file for bankruptcy face an 80% greater risk of dying than those who do not, according to the Journal of Clinical Oncology.
"The consequences are huge and cascading," said Alyce Adams, PhD, MPP, a professor of health policy and of epidemiology and population health at Stanford Medicine. “Patients face bankruptcy, job loss, and worsening health—and their children's educational and career options may be cut short as well.”
In this policy brief, Adams and her colleague, Mateen Ghassemi, MPH, a medical student at Howard University, examine the role of Medical Financial Assistance (MFA) Policy in reducing financial toxicity in cancer care. They lay out the case for how these programs can be critical lifelines for some cancer patients but vary widely in accessibility and generosity. Twenty states, including California, have proposed or passed legislation to standardize eligibility criteria for MFA programs and set certain minimum standards that exceed the federal standard.
In general, MFA programs—which apply to all health expenses, not just cancer—combine forgiveness of medical debt with lower out-of-pocket costs for future care, supporting both insured and uninsured patients in non-profit, for-profit, and government-owned hospitals. Hospitals and health systems seeking nonprofit tax-exempt status (Section 501(c)(3) from the Internal Revenue Service offer MFA as part of the required provision of “community benefits”.
The policy brief gives policymakers and government planners, hospital administrators and health policy researchers a better understanding of the impact of these MFA programs. Research has found that MFA programs increase health service utilization, including prescriptions for medications to treat chronic disease and laboratory testing and follow up. For example, abnormal cholesterol detection nearly doubled and prescriptions for diabetes and depression increased by approximately 26% and 33%, respectively. These findings underscore the potential of MFA programs to improve access to medical care and reduce financial barriers.
“Understanding the intricacies of the policy landscape enables clinicians to advocate for their patients effectively, bridging the gap between hospital and outpatient settings and contributing to better overall patient care and outcomes,” Adams and Ghassemi write. “Addressing the financial challenges directly will not only enhance patient access to cutting-edge therapies but also improve the quality of life for those battling cancer.”
