Unrestricted Payment Program for Cancer

Recruiting at 1 trial location

Overseen By Ari Bell-Brown

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Fred Hutchinson Cancer Center

Disqualifiers: Metastatic cancer, Medicaid enrollee, Hospice, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 5

Duration: 3 months

20 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the Unrestricted Cash Payment Program treatment for cancer?

The Oncology Medical Home program shows that restructuring cancer payments can improve patient care by focusing on patient needs and reducing unnecessary hospital visits. This suggests that payment models like the Unrestricted Cash Payment Program could enhance cancer treatment effectiveness by aligning financial incentives with patient outcomes. ^{1 2 3 4 5}

How does the Unrestricted Cash Payment Program treatment differ from other cancer treatments?

The Unrestricted Cash Payment Program is unique because it focuses on restructuring cancer payments and care by eliminating financial dependence on drug margins and aligning payments with patient outcomes. It enhances payments for cognitive services and rewards improvements in patient care, unlike traditional treatments that primarily focus on medication and procedures. ^{2 6 7 8 9}

What is the purpose of this trial?

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.

Research Team

Veena Shankaran, MD

Principal Investigator

Fred Hutch/University of Washington Cancer Consortium

Eligibility Criteria

This trial is for early-stage cancer patients who are struggling financially. It aims to help those who might skip treatment to work or pay bills, like rent and food. To join, participants must be newly diagnosed with cancer and have financial concerns.

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

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a preloaded cash card once monthly for 3 months, with Arm A receiving $1000 and Arm B receiving $100

3 months

3 visits (monthly)

Follow-up

Participants are monitored for financial and clinical outcomes post-treatment

6 months

2 visits (3 and 6 months post randomization)

Treatment Details

Interventions

• Unrestricted Cash Payment Program

Trial Overview The PAYMENT Trial is testing if giving cancer patients a cash card every month with no spending restrictions helps them financially and improves their health outcomes. The study involves interviews, reviewing medical records, support services, and surveys.

Participant Groups

Group I: Arm A (high payment schedule) Experimental Treatment 4 Interventions

Patients receive a $1000 preloaded cash card once monthly for 3 months.

Group II: Arm B (low payment schedule) Active Control 4 Interventions

Patients receive a $100 preloaded cash card once monthly for 3 months.

Who Is Running the Clinical Trial?

Fred Hutchinson Cancer Center

Lead Sponsor

Trials

583

Recruited

1,341,000+

SWOG Cancer Research Network

Collaborator

Trials

403

Recruited

267,000+

National Cancer Institute (NCI)

Collaborator

Trials

14,080

Recruited

41,180,000+

Oregon Health and Science University

Collaborator

Trials

1,024

Recruited

7,420,000+

References

1. New Zealand pubmed.ncbi.nlm.nih.gov

Outcome-Based Payment Schemes: What Outcomes Do Patients with Cancer Value? [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Lessons from an oncology medical home collaborative. [2019]

3. United States pubmed.ncbi.nlm.nih.gov

Improving Medical Oncology Quality Through Peer-to-Peer Consultation. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Association of Oncologist Participation in Medicare's Oncology Care Model With Patient Receipt of Novel Cancer Therapies. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Improving quality of care in oncology through healthcare payment reform. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Partnership and empowerment program: a model for patient-centered, comprehensive, and cost-effective care. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Head and neck cancer care at a community-based teaching hospital. [2018]

8. England pubmed.ncbi.nlm.nih.gov

Emergency department utilization by patients with gynecologic cancer in the United States. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Alternative payment and care-delivery models in oncology: A systematic review. [2023]