The Oncology Financial Counseling Program: An initiative to reduce the burden of financial toxicity among patients with cancer at a tertiary care center.

174 Background: Financial toxicity is an adverse consequence of cancer treatment, with emotional and practical effects. One possible mitigation strategy is financial counseling, which early data has shown can reduce financial distress. Methods: We initiated an Oncology Financial Counseling Program (OFCP), which connects financial counselors with patients to aid in financial assessments and guidance. This is an ongoing multicenter initiative within NewYork-Presbyterian (NYP). Referred patients are adults with cancer seen within our system who express concerns related to treatment cost, self-refer, or are identified due to outstanding balances or high out-of-pocket costs (OOP) or deductibles (> $2,000). In March 2025, the OFCP was launched at NYP-Columbia and NYP-Queens, with plans for expansion while undergoing iterative Plan-Do-Study-Act cycles. Exclusion criteria include patients enrolled in a clinical trial. Metrics tracked include number of referrals and enrollments. Demographics collected include tumor type, race, and age. Services provided are tracked including referrals to the insurance marketplace, medication cost assistance programs, financial aid or grant/foundation programs, and payment plans. In our upcoming iteration, we plan to implement Outcomes measures utilizing an abridged Comprehensive Score for Financial Toxicity (COST) instrument, a 5-point Likert type scale. This will evaluate patient-reported financial toxicity pre- and post-intervention to assess mitigation. Additional surveys will measure satisfaction with the OFCP. Results: As of May 12, 2025, 207 patients were referred, 159 at NYP-Columbia and 48 at NYP-Queens. By this date, 122 patient counseling encounters were completed, and 27 patients had declined. Most identified patients (85%) were counselor-referred due to concern for outstanding balances or high deductibles/OOP, 11.1% were referred by a provider, and one patient self-referred (0.5%). Of those referred, 53% were male and 47% female, 34.4% White, 25.9% two or more races, and 17.9% Black. The most common cancer diagnoses were breast (20.3%), brain (7.2%), and lung (5.8%). Of those counseled, 30 were referred to co-pay assistance programs, 37 to hospital financial aid, 9 to the insurance marketplace, and 8 were enrolled in grants/foundation programs. Over $360,000 in co-pay assistance and grants was awarded to enrolled patients in a two-month period. Conclusions: We aim to reduce the financial burden of oncology care via implementation of a structured counseling process which has shown promising uptake and significant co-pay assistance. Our program has plans to expand to five additional NYP locations by January 2026 with additional data on patient-reported outcomes and satisfaction. Lessons learned during our initial roll-out will inform broader adoption across oncology practices.