Evidence map›Paper›PMID 41498983›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026

Financial concerns of adults with cancer using patient navigation services offered through employer-sponsored benefits.

Minal R Patel, Jaclyn Marshall, Guanghao Zhang, Kexin Feng, Victoria H Davis, Allyson Day

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Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Minal R PatelDepartment of Health Behavior & Health Equity, School of Public Health, University of Michigan, 1415 Washington Heights, SPH 1, Room 3810, Ann Arbor, MI, 48109-2029, USA. minalrp@umich.edu.
Jaclyn MarshallIncluded Health, San Francisco, CA, USA.
Guanghao ZhangDepartment of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Kexin FengDepartment of Economics, Michigan State University, Lansing, MI, USA.
Victoria H DavisDepartment of Health Behavior & Health Equity, School of Public Health, University of Michigan, 1415 Washington Heights, SPH 1, Room 3810, Ann Arbor, MI, 48109-2029, USA.
Allyson DayDepartment of Health Behavior & Health Equity, School of Public Health, University of Michigan, 1415 Washington Heights, SPH 1, Room 3810, Ann Arbor, MI, 48109-2029, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDespite insurance coverage, cancer patients often face significant financial burdens. This study examined how commercially insured cancer patients utilize employer-provided virtual healthcare navigation services for financial concerns.

methodsWe analyzed chat conversations between care coordinators and members with cancer who used virtual navigation services provided by Included Health during 2022-2023-a third-party vendor contracted by employers to deliver navigation as an ancillary benefit. Included Health is not an insurance company and does not approve claims, determine coverage, or make payment decisions. Services included benefits routing, provider search, clinician referrals, care management, and expert medical opinions. Using natural language processing, we categorized financial discussions into four levels: no financial mention, financial inquiry, financial concern, and financial stress. We used chi-square and t-tests to examine differences across categories.

resultsOf 18,001 eligible cancer patients, 27.4% (n = 4937) used navigation services. The most utilized services were benefits routing (49.9%), self-service provider search (42.5%), and care coordinator assistance for finding in-network clinicians (39.3%). Among members using chat functionality, 82% raised financial matters: 30% made financial inquiries (e.g., coverage verification), 37% expressed financial concerns (e.g., insurance payment issues), and 14% reported financial stress affecting well-being. The remaining 18% had no financial mentions. Members reporting financial stress were more likely to use concierge referral services (55.4% vs. 44.1%, p < 0.01), expert medical opinions (18.6% vs. 12.4%, p = 0.01), and case management programs (27.9% vs. 17.5%, p < 0.01) compared to those reporting financial concerns without impact.

conclusionsThe high prevalence of financial concerns among commercially insured cancer patients using independent, third-party navigation services demonstrates that insurance alone does not shield patients from financial stress. Members' willingness to discuss financial concerns with care coordinators indicates that virtual navigation services can serve as an important resource for identifying and addressing financial toxicity in cancer care.

Indexed as

Financial StressHealth Benefit Plans, EmployeeNeoplasmsPatient NavigationAdultAgedFemaleHumansInsurance CoverageMaleMiddle AgedCancerFinancial concernsFinancial toxicityPatient navigationVirtual or digital health

Identifiers

PMID41498983

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.