The Impossible Choice: The Role of Insurance Design on Financial Toxicity and Access to Care for Individuals with Blood Cancer
Helen Parsons
PhdUniversity of Minnesota
Project Term: June 1, 2023 - May 31, 2026
The overall goal of this project is to understand the role of insurance design on financial toxicity and access to care among individuals with blood cancer. To understand this interplay, we will use a unique and innovative linkage of the 2012-2019 Colorado Cancer Registry (CCR) to the 2013-2021 Colorado All-Payer Claims Database and the LexisNexis and TranUnion financial and life event databases. Our specific aims are to 1) Estimate the number of individuals with blood cancer who are potentially underinsured over time relative to individuals with solid tumors or no history of cancer; 2) Examine the relationship between being underinsured and experiencing financial toxicity after diagnosis in individuals diagnosed with blood cancer relative to those with solid tumors or no history of cancer; and 3) Examine differences in access to cancer care including time to treatment, treatment intensity and survival in underinsured individuals with blood cancer versus those with more generous insurance coverage.
The cost of cancer care has been steadily rising, and patients are bearing more of the financial burden, paying increasingly larger portions out of their own pockets for their care. The financial hardship associated with these increased costs can lead to poor treatment adherence and outcomes. Additional research is needed to understand the relationship between insurance design, financial hardship, and treatment outcomes among blood cancer patients over time. This project will explore the relationship between insurance design and financial hardship among blood cancer patients compared to those with solid tumors or no history of cancer. Additionally, the influence of financial hardship on the relationship between insurance design and treatment outcomes will be explored, while also evaluating potential geographic and racial/ethnic disparities. We will focus on patients over seven years in Colorado and will draw on publicly available tumor registry data, insurance claims data, and financial data. The findings may contribute to policy solutions related to insurance benefit design in individuals with blood cancer, including regulations for working-aged adults.