The Future of Nonprofit Patient Assistance

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By Gwen Cooper, CEO of Accessia Health

Rising healthcare costs are sweeping the nation and are now trending faster than the rate of inflation. According to a 2021 U.S. Department of Health and Human Services (HHS) report, more than $369 billion is spent annually on prescription drugs at pharmacies, averaging over $1,500 per individual per year and impacting over 60% of the American population.

In an effort to curb rising costs, many politicians, providers, and healthcare institutions are working on solutions like the Prescription Drug Pricing Plan, introduced by President Biden at the end of 2021. With his proposed pricing plan, Medicare would be granted authority to negotiate drug prices for patients receiving high-cost prescription drugs, cap out-of-pocket costs for seniors at $2,000 per year, and keep insulin prices less than $35 per month per individual.

While there are solutions in the works, they have a fatal flaw: Where is the voice of the patient?

This is where nonprofit patient providers (PAPs) step in. 

PAPs are designed to support patients and families struggling with the burden of medical expenses and are leading the charge in providing financial support and guidance for qualified individuals. Through healthcare education, financial assistance, insurance case management, and more, nonprofit PAPs serve as the connector between the payer, provider, and the pharmaceutical and technological solutions that directly impact consumers. With funds from PAPs, patients are more likely to be able to actually use the solutions being presented by politicians and healthcare institutions that would otherwise be unaffordable and out of reach. 

The goal of PAPs nationwide is to serve as the bridge between providers and patients so they can access the healthcare treatment they need most. Whether it’s 100% of the cost or a small portion of the total payment, PAPs are able to provide funds to ensure the patient is able to receive exactly what they need, when they need it. By giving them the means to pay for their own treatment, PAPs work to encourage the patient to be an active participant in their healthcare journey. 

For example, a qualifying patient diagnosed with chronic lung disease received funding from a patient assistance program to pay for his medications and transportation to and from medical appointments. With this financial support, the patient lived six years longer than doctors originally anticipated. When his family called personally to express their appreciation for the years of additional time they had with their father, you could feel the emotion through the phone lines. What we do matters!

As the cost of healthcare continues to rise not only in the U.S., but around the world, we must spread the word of PAPs to ensure they are known, recognized, and fully supported. The number of patients on waitlists for funding is growing by the day; currently, Accessia Health alone has hundreds of patients on waitlists, with dozens of patients and families calling daily for information on our programs and available support. Without PAPs, patients can lose access to critical prescriptions, routine check-ups with providers, and/or the ability to pay for health insurance premiums. This can translate into a decline in overall health and lead patients to give up hope for their recovery and overall healthcare journey. 

As healthcare innovation continues to evolve over the next several years, one thing will remain the same: The voice of the patient must be included in all conversations; it must be heard and represented – equally and equitably – to improve the state of healthcare for all Americans. PAPs will be leading the charge by remaining committed to holding powerful conversations with organizations and leaders at the local, state, and federal levels, and will not stop until that goal is achieved.

About the author

Gwen Cooper is CEO of Accessia Health. With over 25 years of experience as a patient, caregiver, and working as an executive with provider organizations, Gwen understands first-hand the importance and impact of healthcare. She has a proven track record in doing the policy work needed to make big changes in the healthcare system, including working on notable Federal advocacy campaigns. At the state level, Gwen has authored and passed new policies in several states (including Kentucky), ensuring people have access to medications, palliative care, addiction treatment, and mental health services. A pioneer in patient assistance organizations, Accessia Health supports patients and their families living with rare and chronic medical conditions, with the end goal of empowering patients to be an active participant in their healthcare journey.