Building a Bridge to Care

For patients receiving cancer care, that support can begin even earlier.

Casey Pickle, a registered nurse who has worked at Hardin Medical Center for 15 years, stepped into the hospital’s newly created nurse navigator role in March after spending much of her career in oncology.

Pickle often meets oncology patients near the beginning of their care journey, assessing what they may need beyond clinical treatment and connecting them with the right resources.

“I just assist the patients in trying to find any avenue to help them support their journey,” Pickle said. “It’s just really helping them bridge the gap a lot of times.”

That may mean helping someone complete indigent care paperwork, determine whether insurance is in place or connect with resources for basic household or transportation needs. Hardin Medical Center has also partnered with Qualify, a third-party organization that searches for grants and copay assistance programs that may help offset the cost of high-priced medications.

For many oncology patients, Pickle is the first point of contact. She works to assess each patient’s needs and, when financial concerns arise, connects patients with Short. Pickle said the majority of the patients she consults who need financial support are referred to Short for additional guidance.

When Cost Threatens Treatment

One patient illustrates how that partnership can work.

Pickle recalled an older woman with Medicare who did not have additional coverage and was struggling to manage the portion of her treatment costs left to her. She was making minimum payments on existing balances and facing the possibility of additional expenses from cancer treatment.

For some patients, Pickle said, those costs can lead them to question whether they can move forward with treatment at all. “Patients will consider not taking a treatment regimen because they just don’t have the finances to be able to afford the drug,” she said.

Working together, Pickle and Short helped connect the patient with Hardin Medical Center’s indigent care program and available grant assistance through Qualify. That collaboration resulted in much more than financial relief.

“We were able to provide her with care without the financial worry and strain,” Pickle said. “She’s just so appreciative and thankful that she doesn’t have that financial burden during this horrific struggle.”

Pickle said the change was visible in the patient’s outlook and demeanor. “There’s so much that goes into cancer patients’ journeys,” she said. “The last thing we want them to do is have to worry about how they’re going to pay for their care.”

Making Insurance Easier to Understand

Cost questions are not limited to oncology.

One of the most common sources of confusion Short encounters involves Medicare Advantage plans. Some patients believe the plan they selected will serve as secondary coverage to traditional Medicare. They may not realize the Advantage plan has become their primary insurance or that deductibles, copayments and other out-of-pocket costs may still apply.

“They believe that they’re not going to owe anything,” Short said. “I have to explain that those Advantage plans are not a secondary to their Medicare, and this is why they’re getting bills.”

High-deductible plans can create similar surprises. Other patients contact Hardin Medical Center because an insurer or health-sharing plan wants an exact price before care is delivered. That may be straightforward for a single imaging service but more difficult for surgery or childbirth, where services may change during care.

Patients often call without fully understanding what their plan has requested. Short begins by listening. “That is the first thing—to listen and find out what part of it they are truly confused about,” said Valerie Moss, revenue cycle manager at Hardin Medical Center.

Listening Before Explaining

Sometimes the patient needs help reading a bill. Sometimes they need to understand an explanation of benefits. Sometimes they need a payment option or an assistance program. Sometimes they simply need an opportunity to express what they are worried about. “Some people just need to tell somebody,” Short said.

Once she understands the question, Short tries to translate the information into practical terms. “I want to explain so they can understand,” she said. “I’ve had patients tell me, ‘You do a wonderful job. I wish I could explain this stuff [healthcare] that well.’”

That clarity can change the tone of a conversation. The balance may not disappear, but the patient can leave knowing what it represents, what assistance may be available and what to do next.