Abolish Parking Fees for Patients at Cancer Centers

Pam Harrison

May 05, 2020

Cancer centers in the United States should make parking free for patients, because the fees can mount up and become a substantial financial burden for those who come in frequently for treatment, say a group of oncologists.

They illustrate the point with a hypothetical example of a patient with early breast cancer who, after undergoing lumpectomy, comes to the center for 15 sessions of hyprofractionated radiotherapy and to begin endocrine therapy.

"The cost of parking for this acute phase alone would be >$200 out-of-pocket (taking the daily cost of parking as $13)," they note.

"Costs for patients with advanced cancer who require more frequent clinic visits, blood work, imaging tests and infusions will be correspondingly higher," they add.

"We understand the reasons for charging for parking are complex — third-party agencies may run garages, and revenue from parking may pay for nonreimbursed but essential services that ultimately serve patients," say senior author Arjun Gupta, MD, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, and colleagues.

"[But] it seems ethically incorrect to nickel and dime patients for parking charges," they add.

"In 2020, with our multibillion-dollar cancer center budgets, we as health care systems should do everything we can to help patients and caregivers in their time of extreme distress," Gupta and colleagues argue.

"We can do our part by inquiring about parking costs at our own cancer centers, leading change within, and appealing to abolish parking charges for patients and caregivers," they suggest.

Their arguments for abolishing parking fees at cancer centers are outlined in an editorial published online April 3 in JCO Oncology Practice.

Top Hospitals for Cancer

Gupta and colleagues determined the cost of parking at the top 20 hospitals named in 2019 in US News Best Hospitals for Cancer.

"The median parking charge across cancer centers for a 24-hour period was $13 (range, $0 – $36)," they observe.

However, most centers had rolling rates that depended on the number of hours a patient had to leave their car in the garage.

Some centers offer weekly or monthly parking rates and discounts or free parking for senior citizens and patients who receive cancer treatment that day.

Others offer parking vouchers, so at least some cancer centers do make an effort to reduce the cost of parking for patients undergoing treatment for cancer.

On the other hand, the parking charges can mount up quickly, as the authors illustrate with their example of the breast cancer patient whose parking fees were more than $200.

"Whatever the exact costs of parking over a care period...we believe an ethical approach is to provide free parking to all patients undergoing evaluation and treatment," Gupta and colleagues write.

This has already been done by some organizations in the United Kingdom, for example, which have argued for the abolishment of parking fees for cancer patients.

The Irish Cancer Society released hospital parking guidelines; now, almost 40% of public hospitals in Ireland offer free parking to patients with cancer.

In the United States, the American Cancer Society Road to Recovery program and the Leukemia and Lymphoma Society Travel Assistance Program are designed to help patients cover travel costs.

Providers can do their bit to reduce the burden of travel for treatment by consolidating appointments whenever possible, selecting less aggressive or less frequent therapeutic strategies, and choosing treatment centers closer to where patients live to minimize patients' need to travel.

The editorialists acknowledge that offering free parking may result in a significant decline in revenue for the cancer center.

They also acknowledge that not every patient needs help with out-of-pocket costs, nor does every patient drive to their appointments. Some are likely to use ride-sharing apps or public transit or have a caregiver drop them off, so they have no need to park.

However, a recent survey of breast cancer patients undergoing treatment found that close to 50% of some 800 patients surveyed indicated that they drove to the cancer center for treatment.

Although the survey did not focus specifically on parking fees, 48% of participants said that the cost of transportation was a barrier to receiving treatment.

"We need more...initiatives to encourage safe and convenient travel for patients with cancer," the editorialists conclude.

The editorialists have disclosed no relevant financial relationships.

JCO Oncol Pract. Published online April 3, 2020. Full text

For more from Medscape Oncology, follow us on Twitter: @MedscapeOnc.

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