A Pilot Unrestricted Payment Program for Early-stage Cancer Patients: the PAYMENT Trial

Purpose

This clinical trial studies whether an unrestricted cash payment program can be used to improve financial and clinical outcomes in early-stage cancer patients with financial concerns. A cancer diagnosis can have poor financial outcomes, and the cost of cancer treatment can lead to high medical debt and financial hardships for the patient and family. Financial hardship during cancer treatment is associated with adverse outcomes including poorer quality of life, lower treatment compliance, more aggressive use of hospital-based care, and worse survival. Newly diagnosed cancer patients with financial concerns may avoid treatment entirely so that they can continue to work and maintain income, provide for their families, or pay rent. An unrestricted cash payment program provides patients with a preloaded cash card once monthly. The patients can choose what to use the card to pay for and may include items like food, rent, or utilities. This provides a period of guaranteed income for the patients and may prevent them from falling into poverty and improve financial and clinical outcomes.

Condition

  • Malignant Solid Neoplasm

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Criteria

Inclusion Criteria:

- Age >= 18

- Ability to understand English

- Ability to understand and willingness to sign a written informed consent document.
Legally authorized representatives may sign and give informed consent on behalf of
study participants

- Within 90 days of a non-metastatic or early-stage solid tumor receiving or
rescheduled to receive treatment in the neoadjuvant, adjuvant or definitive setting
for curative intent. Eastern Cooperative Oncology Group (ECOG) performance status
(PS) 0-2

- Current cancer patient at PeaceHealth (Southwest Medical Center or St. Joes)

- Not current Medicaid enrollee

- Not enrolled in hospice

- Screens positive for financial fragility

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Health Services Research
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Arm A (high payment schedule) 		Patients receive a $1000 preloaded cash card once monthly for 3 months.
  • Other: Electronic Health Record Review
    Ancillary studies
  • Other: Interview
    Ancillary studies
  • Other: Support
    Receive $1000 preloaded cash card
    Other names:
    • Supportive - procedure intent
  • Other: Survey Administration
    Ancillary studies
Active Comparator
Arm B (low payment schedule) 		Patients receive a $100 preloaded cash card once monthly for 3 months.
  • Other: Electronic Health Record Review
    Ancillary studies
  • Other: Interview
    Ancillary studies
  • Other: Support
    Receive $100 preloaded cash card
    Other names:
    • Supportive - procedure intent
  • Other: Survey Administration
    Ancillary studies

Recruiting Locations

PeaceHealth St. John Medical Center
Longview, Washington 98632

PeaceHealth Southwest Medical Center
Vancouver, Washington 98664

More Details

Status
Recruiting
Sponsor
Fred Hutchinson Cancer Center

Study Contact

Ari Bell-Brown
206-667-7624
abellbro@fredhutch.org

Detailed Description

OUTLINE: Patients are randomized to 1 of 2 arms. ARM A: Patients receive a $1000 preloaded cash card once monthly for 3 months. ARM B: Patients receive a $100 preloaded cash card once monthly for 3 months. After completion of study intervention, patients are followed up 3 months and 6 months post randomization.