CAFE Supplement 1 - Insurance Supplement

项目摘要 本申请是为了响应被标识为NOT-CA的特别利益通知（NOSI）而提交的- 21-055.与癌症及其治疗相关的费用可能对患者的能力产生巨大影响 支付健康保险、健康需求和基本需求（例如，食物、住房、庇护所）。考虑到 健康保险覆盖范围，其抵消OOP成本的能力，以及个人改变保险的能力， 保险范围是与OOP支出相关的可修改因素。我们建议利用独特的 通过拟定的补充研究进行的CAF 4随机试验（R 01 CA 237322）的基础设施， NOT-CA-21-055。拟议的补充研究是在父母资助的范围内，一项随机试验， 为新诊断出癌症的人提供财务导航干预。补充研究的目标是 评估健康保险计划覆盖范围和OOP成本的模式，在诊断周围的时间， 侵袭性癌症，以及了解癌症患者改变健康状况的经历 在侵入性癌症诊断后的保险计划。具体目标1：评估健康保险模式 在癌症诊断之前和之后的覆盖范围和自付支出中， KPNW和KPWA被诊断为癌症。具体目标2：对成年成员进行定性评估 使用描述性现象学方法改变健康保险计划覆盖范围的癌症患者。 建议的混合方法补充研究将提高我们对保险覆盖范围变化的理解 作为癌症护理成本的一个可修改因素，很有可能为未来的战略提供信息，以减少患者的外出 与癌症护理相关的口袋支出。

Project Summary This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA- 21-055. The costs associated with cancer and its treatment may have a tremendous impact on patients’ ability to pay for health insurance, health needs, and basic needs (e.g., food, housing, shelter). Given the variation in health insurance coverage, its ability to offset OOP costs, and individuals’ ability to change insurance, insurance coverage is a modifiable factor relevant to OOP spending. We propose to leverage the unique infrastructure of the CAFÉ randomized trial (R01CA237322) via the proposed supplemental study in response to NOT-CA-21-055. The proposed supplemental study is within the scope of parent grant, a randomized trial of a financial navigation intervention for people newly diagnosed with cancer. The supplemental study goal is to assess the patterns of health insurance plan coverage and OOP costs in the time surrounding a diagnosis of invasive cancer, as well as to understand the experiences of people with cancer who switched health insurance plans following an invasive cancer diagnosis. Specific Aim 1: Evaluate patterns of health insurance coverage and out-of-pocket spending prior to and following a cancer diagnosis, among adult members of KPNW and KPWA diagnosed with cancer. Specific Aim 2: Conduct a qualitative assessment of adult members with cancer who switched health insurance plan coverage using a descriptive phenomenological approach. The proposed mixed-methods supplement study will improve our understanding of insurance coverage change as a modifiable factor of cancer care costs, with high potential to inform future strategies to mitigate patient out of pocket spending related to cancer care.