Editor’s Note: Wentworth-Douglass Hospital in New Hampshire, a subsidiary of Massachusetts General Hospital, is the seacoast’s leading medical center offering comprehensive multi-specialty care. The Seacoast Cancer Center at Wentworth-Douglass Hospital offers a comprehensive program of cancer treatment that includes medical and radiation oncology along with surgical services. 

Since early 2020, Seacoast has partnered with TailorMed to strengthen the Cancer Center’s efforts to remove financial barriers to care. We sat down with Seacoast’s Director of Business Operations Adrienne Coleman and Business Systems Manager JoLynn Seaver to discuss their vital work—and how they’re optimizing their use of our platform to help more patients in need.

**

TailorMed: Adrienne and JoLynn, tell us about each of your roles. What are your primary responsibilities at the Seacoast Cancer Center?

Adrienne Coleman: As Director of Business Operations, my role is to oversee the business side of the Cancer Center’s work, including the budget and prior authorizations. But then there’s operations, which is everything: our day-to-day clinical activities, as well as provider and patient relations. 

I manage all the non-clinical staff. I’m proud of the work we’ve done over the past two years. For example, we’ve built an internal revenue team, which is not something we had previously. I think we’ve positioned ourselves really well. 

JoLynn Seaver: We wear a lot of different hats. As Adrienne mentioned, we’ve developed our own cancer center revenue team. This includes our Lead Financial Counselor Nancy Croteau, who is the primary user of the TailorMed system, two revenue coordinators, and a newly added revenue analyst. We also work closely with our new prior authorization pharmacist.

In addition to managing that team, I do a little bit of everything. I used to work in IT, so that’s where I started with this project. I also help with different clinical and non-clinical workflows. It’s a lot of project management, encompassing all areas of business and operations.

TailorMed: What are some of the greatest rewards and the greatest challenges of your work?

AC: I love working in operations because no two days are the same, which can be both a reward and a challenge! I feel very passionately about the patients we treat and it’s incredibly rewarding to be able to make a difference in their lives. 

As a leader, I can’t do what I do without a great team. I’m really blessed to work with two phenomenal managers, JoLynn and Laurin, and Beth Flowers, our Cancer Services Coordinator. We all bring something different to the table. 

Since we’re taking care of all the behind-the-scenes pieces that keep the clinic going, it can sometimes feel exhausting. But we’re not in it for the recognition; we’re in it to do the work we love.

JS: I agree! The team is the greatest reward. We’ve built a team made up of people who are passionate about patients. We use the word “passion” a lot, which can be a reward as well as a challenge, because you can’t prioritize everybody at the same time. That can sometimes create barriers, but overall, we feel very fortunate.

TailorMed: Financial toxicity is a growing problem among cancer patients. In a recent American Cancer Society survey, half of cancer patients said that they had incurred medical debt to cover costs of care. What types of financial struggles have you observed among patients at Seacoast and how have these challenges impacted both clinical outcomes as well as Seacoast’s financial performance?

JS: We see it every day. We’re very diligent about checking a patient’s insurance and benefits. Nancy looks at every patient, so if she identifies someone who doesn’t have insurance or just Medicare Part A, she tries to find assistance for them. One challenge is that when a patient has insurance that will cover certain medications over others, we sometimes have to initiate the drug that the insurance company prefers, rather than what the provider prefers. Another challenge is that we’re on the edge of the state, so if a patient has to cross state lines into Massachusetts for care, their New Hampshire-based insurance may not cover it.

If patients come in with a bill they can’t afford, we do our best to help them. Even a $500 co-pay could lead to financial hardship if the patient has a limited income. The stress associated with financial toxicity is definitely real. 

AC: We’re also dealing with such high-cost drugs. We could have one drug that’s $50,000 … and that’s per dose. So, if a drug gets written off or there’s a denial, it gets a lot of attention. We’re fortunate to have a pharmacist who now oversees the prior-authorization process for those drugs. We think this new role will positively impact both our clinical outcomes as well as our financial performance.

TailorMed: What are some other ways the Seacoast Cancer Center has committed to removing financial barriers to care?

JS: We’re committed to ongoing communication. We work very closely with the patient, the clinical team, the provider, and anyone getting authorization or helping them with their bill. We follow up and do whatever we can on patients’ behalf.

AC: Our goal is to keep building our internal revenue team. We’ve been lucky to employ true experts in a variety of different areas. Together, we will continue to develop processes to remove financial barriers.

TailorMed: What were some of the challenges your financial navigation team encountered that motivated you to consider a technological solution?

JS: I’m an IT person, so anytime you can implement a system to improve your efforts, I’m in favor of it. Nancy is our financial counselor on the front lines. Rather than Nancy looking for financial assistance for patients, which entails a significant amount of manual work, TailorMed brings those cost-saving opportunities to her. Because we’re so patient-focused, we were interested in any technology that could help reduce financial toxicity.

TailorMed: You recently implemented a process to optimize your team’s usage of our platform and standardize the distribution of patient financial resources. Tell us a bit about this project. 

JS: We went live with TailorMed when the pandemic had just started. The world was shutting down and our workflows were very disrupted. Our staff who were trained to use TailorMed didn’t have the opportunity to utilize the system efficiently. The purpose of the optimization project was to look at our lessons learned, our pain points, and our goals.

As a team, we wrote down the steps for using the system, including how to identify the best patients for the best funds available—and make sure the funds are being appropriately dispersed back to the patient. We then looked at the roles and responsibilities for accomplishing those tasks, and assigned them based on each team member’s strengths. 

We developed a standardized process, so that if I sat down today, I could follow the steps to find funds, vet patients, and determine who is eligible. Ultimately, our main objective is to be able to help more patients in need and that’s what we’ve been able to accomplish. In the first quarter of 2022 compared to 2021, we doubled the number of approvals for patient financial assistance. 

AC: For the past three years, we’ve had a tight budget. Nancy was doing literally everything from a financial counseling standpoint, so TailorMed has really helped. It took a while because there’s always some doubt about, “Well, what is this system going to do?” But now, it’s such a complement to the services we provide and we have a whole team to support it. I’m excited for the future and to see what we can do. 

TailorMed: What advice would you give to other healthcare leaders who are investigating ways to address access and affordability among the patients their organizations serve?

JS: First and foremost, you need people embedded in your organization who understand your patients’ financial needs—people who truly care and advocate for them the way Nancy does.

It’s also important to choose partners who support your goals. TailorMed has been so responsive, offering support every step of the way. I never see changes to the user interface or platform that are solely for the sake of making changes. TailorMed makes incremental adjustments that are worthwhile to the end user.

AC: Financial toxicity is on everybody’s mind, but it’s not always a priority. It’s our job as healthcare leaders to take care of our patients clinically, emotionally, but also, fiscally. Implementing any services that can make care more accessible and affordable should be a no-brainer. A lot of our reimbursement is based on patient satisfaction, and improving financial experience is an important part of building patient loyalty. If our patients are happy, I truly believe the rest falls into place.