Financial toxicity is a prevalent issue in modern health care. Patients facing long-term and chronic care deal with the burden every day. Health care professionals must address this nonclinical aspect of patient well-being, providing them with information and resources to alleviate some stress.
Financial Toxicity in Health Care
Financial toxicity refers to the stress patients experience as they navigate expensive care costs. When patients have chronic conditions, financial burdens can negatively affect their overall health. Health care professionals must support patients and their loved ones in alleviating this burden to avoid stress-induced health decline.
Out-of-pocket costs and medical debt are key contributors. In 2024, out-of-pocket costs totaled $556.6 billion, a 5.9% increase. The average person cannot afford these bills as prices continue to rise, especially without financial assistance.
Also in 2024, 36% of households in the United States had medical debt, either from overdue bills or extended payment plans. Since financial burden is becoming more common in the health care industry, professionals should provide support for long-term care patients.
How to Reduce Costs Associated With Long-Term Treatments
Health care professionals must work with patients undergoing palliative care, cancer treatment or elder care to reduce as many health care costs as possible. Having thoughtful discussions, leveraging programs and providing support can help with this financial burden.
Initiate Thoughtful Discussions
One way to reduce costs is to have thoughtful discussions early on about the overall cost of treatment and how patients and their loved ones can manage it. Health care professionals must facilitate these discussions to create a supportive environment where patients can ask questions.
During these discussions, health care professionals should help clients create a plan that cuts costs where possible. They should also help patients gather legal documents, such as wills, which are essential for long-term care. Another potential topic is Medicaid and its eligibility requirements. Informing the patient and giving them a detailed financial plan can alleviate a lot of stress and prevent them from discovering expenses after the fact.
Leverage Technology and Programs
Many technologies and programs exist to help with financial costs. Health care professionals should tell patients about any resources, programs or insurance offerings they may qualify for. There are price transparency tools, relevant patient assistance programs and resources on complex insurance formalities.
The government provides several programs that patients potentially qualify for. Health care professionals and patients must research each option to determine whether they qualify.
- Medicare: This program helps older adults with disabilities or serious health conditions who are 65 years old or older.
- Medicaid: This program helps low-income patients, among others.
- Program of All-Inclusive Care for the Elderly: This program is available in select states and combines Medicare and Medicaid.
- State Health Insurance Assistance Program: This program provides additional counsel and assistance for Medicare, Medicaid and other options.
- Social Security Administration programs: This program helps retired patients who meet the Social Security Administration’s definition of disability.
- Department of Veterans Affairs: This program is available to qualifying veterans who require long-term care.
Implement a Team-Based Approach
Health care professionals should work with social workers, financial counselors, law firms and pharmacists to create a support system for the patient outside of their loved ones. Family and friends are going through a lot, so professionals can navigate the complexities and explain their significance.
Also, the support system should feature many experts in accompanying fields to provide the most expertise in medicines, equipment, procedures and legal programs. Professionals can help patients cut costs and avoid making hard decisions alone, which can be a great way to avoid stress.
Best Ways to Protect Assets While Qualifying for Medicaid
Patients who want to qualify for Medicaid without jeopardizing their assets, such as property or valuable heirlooms, can protect them in a few ways. One option is to grant a beneficiary ownership of their property while still preserving their right to live there. Another option is to create an income stream from spare cash to meet immediate needs while complying with Medicaid’s regulations.
Patients can also establish a Medicaid Asset Protection Trust (MAPT). This allows them to transfer assets into an irrevocable trust, which is managed by a trustee. For this strategy to be effective, the transfer must be made at least five years before applying for Medicaid, due to the program’s five-year “look-back” rule.
While the patient gives up direct control over the assets, a properly structured MAPT accomplishes two key goals — the assets are not counted for Medicaid eligibility, and they are protected from estate recovery after the patient passes. Given the complexity and critical timing involved, health care professionals should strongly recommend that patients work with an experienced elder law firm to navigate this process.
Ettinger Law Firm is a leader in elder law, helping people protect their financial assets while still qualifying for Medicaid. It is the largest elder law and trust/estate planning firm in New York with 12 locations. Ettinger Law Firm has a deep understanding of the MAPT. The firm can help patients navigate the program’s stipulations, such as restrictions on selling the patient’s house and on losing property tax exemptions.
To give patients adequate time to process the potential of working with a law firm, Ettinger Law Firm provides ample time to make the decision. There are also no required payments until the client signs the document, including calls, emails, legal reviews and consultations.
Advocating for Patients as a Health Care Professional
Mitigating financial toxicity is a large component of ethical and professional patient advocacy. Facilitating conversations, discussing programs and providing a team of support are some ways health care professionals can alleviate the financial burden on patients. Managing finances can lead to better health outcomes, as patients no longer worry about affording their care.
