Editor’s Note: New England Cancer Specialists (NECS) is the region’s largest medical oncology group, serving patients at four locations in New Hampshire and Maine. Last year, NECS became the first-ever Affiliate Member of the Dana-Farber Cancer Institute. NECS believes that treating cancer requires caring for the whole patient, medically and financially. To help patients overcome cost barriers, NECS created its financial advocacy program more than a decade ago.
Since 2018, NECS’s financial advocates have used TailorMed to assist over 3,300 patients and acquire more than $87 million in approved assistance. We sat down with NECS’s Robin Letarte, Financial Advocate and Prior Authorizations Manager, to chat about her personal journey—and how TailorMed has helped her team take their vital work to the next level.
TailorMed: Tell us a bit about your professional background and what motivated you to become a financial advocate.
Robin Letarte: I had been working in retail for about 15 years when my second child was diagnosed with autism. I had to stop working to focus on his needs. I became a strong advocate, starting support groups and seeking out people to guide me. Over time, my advocacy became a passion.
Eventually, I went back to school and got certified in coding. I found a job here at New England Cancer Specialists, working in the billing office. After two years, a financial advocate position opened. I thought, this is right up my alley!
I found my passion through my son’s situation, but this role has allowed me to become passionate about helping cancer patients as well. Life takes you places, but ultimately, you land where you’re supposed to land. Today, my son’s doing fantastic; I truly believe a lot of that comes from advocacy and bringing the right people into our lives. And now, I’ve turned that around to help our patients.
TailorMed: With the costs of cancer care on the rise, what types of financial struggles have you observed among patients at NECS?
RL: The pandemic and the uncertain economy have intensified our patients’ struggles. We’re seeing a lot of people dealing with food insecurity. We also have patients from Northern Maine where there’s not a lot of access to care. They’re coming this way for their treatments and there’s a big transportation need. Housing is also an issue for people in our area.
Beyond that, healthcare literacy is a challenge. Many people don’t understand how insurance works, what that means to them as consumers, and how it all relates to their out-of-pocket costs. So, we do seminars and work with a Medicare advisor to provide that education for patients.
TailorMed: What are the greatest rewards of your work?
RL: As financial advocates, we become close with our patients, and we start to feel the weight of their situations on our shoulders. The reward comes when we hear from patients who say, “Oh my gosh! You have no idea what you’ve done to help me.” I’ve had patients sobbing on the phone because the financial support we’ve provided meant so much to them.
There are not a lot of jobs out there where there’s this type of reward. That’s what keeps us going as advocates. We’ve been lucky on our team to have people who are just as passionate as I am, who realize the value in what we do. We’re making a huge difference.
TailorMed: You’ve worked at NECS for over 13 years. How has the financial advocacy program evolved?
RL: Years ago, there were only two financial advocates working in our offices. Since then, our organization has added more sites and physicians. I also remember when only a few copay cards were available. The challenge was that there weren’t many assistance programs. Today, between the foundation grants, copay cards, and nonmedical grants, there are so many resources out there.
As our organization, financial advocacy, and treatment in general have evolved, this program had to evolve with it. Last May, I took over as the manager of the department. We now have five advocates, and we’re adding positions. We’ve hired prior authorization specialists to work alongside our advocates. We also have a team member who works as a liaison between the advocates and the billing department, which helps us appeal claims.
TailorMed: What were some of the challenges your team encountered that motivated you to consider a technological solution?
RL: Before TailorMed, we had a manual process. We kept lists of patients who might need grants or copay cards. We used spreadsheets and whatever else we could to keep track of those patients. We’d Google different foundations to see which funds were open and what we could access. Then, we’d have to hunt down our papers, trying to find the information we needed to enroll the patient. Since windows of funding close quickly, this led to missed opportunities.
TailorMed: What were your program’s main goals when you implemented TailorMed—and what has been the impact?
RL: Our goal was to have a better system in place whereby when grants opened, we’d have a “one-stop shop.” Rather than using spreadsheets and Google searches, TailorMed has given us a single system and real-time information. The system creates a comprehensive list of funding opportunities for each patient and alerts us when relevant funds open.
It has also given us the tools to be more proactive in our efforts. In our typical workflow, once we review the patient’s benefits, we often realize there’s some assistance they could get. If they have commercial insurance, we automatically enroll them in copay cards. After that, we’ll start looking to grants and foundations. That’s when we’ll call the patient and let them know what’s available to them. During that call, we’ll also collect other details, such as the patient’s income, and input them into TailorMed. Now that we have a centralized space to store this information, we have it on hand when funds open—and we’re ready to stop, drop, and roll.
It used to be that prior authorizations didn’t take as long, and we were able to spend more time with patients one-on-one. Now, because of these lengthy authorizations, we have less time to do a deep dive into each patient’s financial challenges. TailorMed has given us more time back, empowering us to access more resources for patients quickly.
With TailorMed, we’ve increased in the number of people we’re helping and the amount of approved funding we’ve secured. That’s a win-win for our patients and our organization.
TailorMed: What advice would you give to other financial advocacy programs that are exploring technology solutions to serve more patients in need?
RL: With TailorMed, we found the platform that works for our team. We asked ourselves, “What’s most important to our organization?” and we’re using the features that help us meet those goals. As more time is available to us, we plan to learn and utilize additional features.
My advice is, look at other organizations and see how they’re using this technology, but at the same time, don’t worry too much about what others are doing. When it comes to financial navigation technology—or any other digital solutions—find out what suits your environment.
Our team has been very successful with TailorMed, but there are always ways to improve and reach more patients. Everyone in our organization is patient-focused—whether it’s the person in billing all the way up to the physicians. Our actions are based on doing absolutely everything we can for our patients to give them the best possible outcomes.