Going Broke: Financial Concerns of Palliative Care Patients

Betty R. Ferrell, PhD, RN

Disclosures

September 19, 2017

The Financial Burdens of Serious Illness

Attention to a patient's financial concerns requires a thorough assessment of direct and indirect costs of care. Many costs are incurred by families and patients beyond the costs of treatment. And although treatment adherence is important, failure to realistically address financial concerns will only decrease the likelihood that Max will be able to continue treatment. Moreover, the best approach to discussing treatment or financial concerns will be through open communication with the patient and family caregiver together.

The costs of healthcare across all serious illnesses can be devastating to patients and families. Even for patients with healthcare coverage through Medicare or other health insurance plans, the personal costs are enormous, resulting in financial distress and even bankruptcy for a significant number of patients.[1,2,3]

Costs can be significant even in short-term illness, but in chronic or life-threatening illness, they are more devastating. Out-of-pocket expenses for medications, copayment deductibles, and the need to see providers outside of the health plan are but a few of the major expenses faced by patients and families.[4]

The direct financial burdens of the patient's care are often the focus of economic concerns, and less attention has been given to the costs that affect family caregivers. Transportation, missed work, and many out-of-pocket costs can equally devastate family caregivers.[5]

In Max's case, a thorough financial assessment will help identify potential resources and possible ways to reduce out-of-pocket costs or access helpful resources. It's also important to remember that discussing financial issues can be a very sensitive area and may evoke feelings of shame. Unfortunately, the financial coats of serious illness care are enormous and solutions are often limited, so attention to financial concerns is key to quality patient care.

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