Assessing financial advocacy services to enhance patient-centric care.

57 Background: In 2023, the Association of Cancer Care Centers (ACCC) introduced expert consensus-based Financial Advocacy Services (FAS) guidelines. These guidelines offer a framework to ensure equitable financial advocacy (FA) services, encompassing three areas: service functions, program management, and partner engagement. To facilitate the implementation of patient-centric FA, the ACCC's Financial Advocacy Network developed an open-source assessment tool designed for cancer centers to identify quality improvement (QI) opportunities and advance research on organizational FA practices across the U.S. Methods: The assessment tool enables users to assess their organization's performance against the 43 FAS guidelines, with scores from 1 (not performing) to 4 (reliable performance across all areas). The assessment generates total and average scores for each guideline across FA domains and subdomains and incorporates unscored questions regarding organizational demographics, barriers, and readiness. The assessment was distributed to member cancer programs from March 2024 to May 2025, with data analyzed using descriptive statistics to evaluate guideline adherence. Results: Thirty-one cancer programs participated, with 86% classified as community-based and 13% as academic. Only 39% of respondents had a dedicated financial advocate for patient assistance. High adherence was noted for benefits verification, with 78-84% achieving Levels 3 and 4 compliances respectively, reflecting effective insurance verification processes. However, financial distress screening adherence was starkly lower, with only 38-45% of programs conducting regular screenings at Levels 3 and 4 respectively, indicating a notable gap in addressing patients' financial burdens. Staff training on financial advocacy practices was only reported at 30-39% at levels 3 and 4 respectively, revealing insufficient ongoing education for personnel involved in financial counseling. Barriers to effective implementation emerged from qualitative feedback. Challenges included staffing shortages limiting FA service capacity, a lack of standardized screening processes leading to inconsistencies in support, and communication gaps hindering timely financial assistance. Conclusions: There is significant variation in the execution of FA services, indicating that many programs are ill-equipped to address the complex financial needs of cancer patients effectively. Investment in these areas can enhance the overall patient experience, reducing the stress associated with financial burdens and improving treatment adherence. By addressing barriers, cancer programs can create a more supportive environment that empowers patients to focus on their health and recovery, while ensuring that financial toxicity does not hinder access to essential care.