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Evaluation of a novel financial navigator pilot to address patient concerns about medical care costs

M.P. Banegas, J.F. Dickerson, N.L. Friedman, D. Mosen, A.X. Ender, T.R. Chang, T.A. Runge, M.C. Hornbrook
Perm J

Context: Interventions are required that address patients’ medically related financial needs.

Objective: To evaluate a Financial Navigator pilot addressing patients’ concerns/needs regarding medical care costs in an integrated health care system.

Methods: Adults (aged ≥ 18 years) enrolled at Kaiser Permanente Northwest, who had a concern/need about medical care costs and received care in 1 of 3 clinical departments at the intervention or comparison clinic were recruited between August 1, 2016, and October 31, 2016. Baseline and 30-day follow-up participant surveys were administered to assess medical and nonmedical socioeconomic needs, satisfaction with medical care, and satisfaction with assistance with cost concerns. Physicians at both clinics were invited to complete a survey on medical care costs. We assessed participant characteristics and survey responses using descriptive statistics and 30-day change in satisfaction measures using multivariable linear regression models.

Results: Eighty-five intervention and 51 comparison participants completed the baseline survey. At baseline, intervention participants reported transportation (52.9%), housing (38.2%), and social isolation (32.4%) needs; comparison participants identified employment (33.3%), food (33.3%), and housing (33.3%) needs. Intervention participants reported higher satisfaction with care (p = 0.01) and higher satisfaction with cost concerns assistance (p = 0.01) vs comparison participants at 30-day follow-up, controlling for baseline responses. Although most physicians (80%) reported discussing medical care costs with their patients, only 18% reported knowing about their patients’ financial well-being.

Conclusion: We demonstrated the promise of a novel Financial Navigator pilot intervention to address medical care cost concerns and needs, and underscored the prevalence of nonmedical social needs in an economically vulnerable population.

Banegas MP, Dickerson JF, Friedman NL, et al. Evaluation of a novel financial navigator pilot to address patient concerns about medical care costs. Perm J. 2019;23:18-084. PMID: 30939267. DOI:

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Publication year
Resource type
Peer Reviewed Research
Social Needs/ SDH
Patient Experience of Care
Provider Experience of Care
Social Determinant of Health
Economic Security
Housing Stability
Social Support/Social Isolation
Study design
Pre-post with Comparison Group