Editor’s Note: TailorMed empowers healthcare organizations to improve access to financial assistance for patients, including foundation grants. The HealthWell Foundation, which provides a financial lifeline to underinsured Americans, is a leading source of these funds. TailorMed’s Clara Lambert, Director of Financial Navigation and Product Subject Matter Expert, sat down with HealthWell’s Audrey Quartey, Associate Director of External Relations, to discuss HealthWell’s important work—and how navigators can use foundation funding effectively.
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Clara Lambert: Tell us a bit about your role at the HealthWell Foundation.
Audrey Quartey: I have been the Associate Director of External Relations at HealthWell for about ten months. Prior to joining HealthWell, I held a similar role at another foundation for about seven years. As Associate Director, I work with providers and pharmacies, ensuring they understand our programs and processes. I also work to expand our medical specialty society alliances.
CL: For those who may not be familiar with HealthWell, tell us about the genesis of the foundation and its mission.
AQ: We are a national, independent non-profit organization, established in 2003. At the time, Medicare Part D was on the horizon. A group of patient advocates recognized that Medicare patients needed help affording their prescriptions. They had nowhere to turn because the copay assistance programs were restricted to commercially insured patients. For that reason, we got into the copayment assistance space to be able to assist Medicare patients.
Our mission is to reduce financial barriers to care for underinsured patients with chronic or life-altering diseases. Our vision has always been to make sure that no patient goes without healthcare because they can’t afford it. That has been the core of who we are from day one.
Since awarding our first grant in 2004, we have served as a safety net across more than 90 disease areas for more than 822,000 underinsured patients.
CL: What are some of the foundation’s current goals and top initiatives?
AQ: We believe that affordability should not stand in the way of people trying to get better from any condition they may have. Our goal is to expand our medication assistance funds to reach more patients across more disease states. For example, we have a pediatric assistance fund, which supports various diseases affecting children. We also have a cancer-related behavioral health fund to assist patients with out-of-pocket costs for behavioral health services related to a cancer diagnosis. We also opened an emergency/medical workers fund to help with prescription, counseling, psychotherapy, and transportation costs for behavioral health services.
In addition, we want to go beyond copay assistance to other areas where we’ve heard patients need help. For example, we’re also educating our stakeholders through our Real World Health Care blog, where we share insights from national non-profit leaders and healthcare experts on topics ranging from health disparities and barriers to care to behavioral health and caregiving. Most recently, HealthWell was recognized for its efforts by the White House Cancer Moonshot Initiative to “End Cancer as We Know It.” We are honored to now be listed as a resource on the Cancer Moonshot Factsheet, which was published on September 13, 2023.
As part of the initiative, in 2024 HealthWell has committed to providing more than $300 million to underinsured oncology patients to offset out-of-pocket medication costs to enable patients to adhere to prescribed treatment regimens and improve their survival. We will also begin providing financial assistance to qualified clinical trial patients to address disparities in participation in oncology clinical trials. In addition, HealthWell will launch a fund to support oncology caregivers to help with certain out-of-pocket financial needs.
CL: I remember when I first saw the behavioral health fund for oncology patients a couple of years ago. It’s been neat to see how in tune HealthWell has been to what’s affecting patients.
TailorMed’s users include financial navigators and other professionals who help patients access vital resources. What advice would you give navigators, so that they can be good stewards of foundation funds?
AQ: Financial navigators can ensure that they apply for programs that support commercially insured patients, such as manufacturer drug assistance programs. If the patient qualifies for one of these programs and doesn’t have Medicare, then it’s probably best to reserve foundation funding—which is not unlimited—for patients who don’t have anywhere else to turn.
There are also other programs available, such as “Extra Help” for Medicare beneficiaries. Applying for this additional assistance is another way to be a good steward, so that patients can use foundation funds when they are most needed.
CL: I totally agree with that. What do you wish every navigator knew about accessing HealthWell funds?
AQ: A few things: First, it is easy. We have streamlined our process to allow instant approval. If the patient meets our eligibility criteria—which are, they must have insurance that covers the treatment, their income must fall within our income guidelines, and they must be receiving treatment for the disease in the United States or U.S. territory—then about 98% of people who apply for a HealthWell grant get one. The application process takes just over five minutes, and it’s instant approval.
We also have portals to help patients, providers, and pharmacies apply for and manage the grants. Within the portals, we have tools that enable navigators or patients to upload required materials. They can just take a photo on their phone, without having to get to a scanner or a fax machine. In addition, we have real-time fund alerts. This is a good tool for navigators because, as we all know, funds open and close quickly.
If anyone has questions, they can reach out to us through our portals, and our team can provide a portal demonstration or program overview.
CL: In the world of financial navigation, we often talk about “navigating outside the box” to meet patients’ evolving needs. Does the HealthWell Foundation offer specific tools or features that allow navigators to adjust a patient’s assistance as their circumstances change? An example might be that the patient is no longer able to work and loses employer-sponsored health insurance.
AQ: We know that the lives of those we serve are always changing. At HealthWell, we want to say yes, as many times as we can. So, we do welcome feedback, and we would want the navigator or the patient to reach out to us and let us know when circumstances change. This allows us to review their unique situation and determine if there’s a way we can assist.
For example, a patient may have been over our income limit, but now, they do qualify for assistance. Maybe there was a loss of a job, or someone moved out of the house who was contributing to that total income. You can submit the documents to support the change through the portal. We’ll review as early as the next day, or even the same day, and let you know what the determination is.
In this example, the patient may now be on COBRA. So, they might want to switch from using our funding for copay assistance to using it for premium assistance. Or if the patient is now uninsured and doesn’t qualify for our programs, we have resources available on our website; we can offer guidance, even if it’s outside the scope of what HealthWell does.
CL: Many healthcare organizations tend to think of financial toxicity as a cancer problem, but we know it impacts patients with a variety of costly conditions. Tell us about some of HealthWell’s funds outside of oncology.
AQ: We have over 90 disease funds. And two-thirds of these funds are not in oncology. This includes funds for Hepatitis C and multiple sclerosis. Several of these funds require the patient to pay as much as $8,000 out-of-pocket on average.
Recently, we opened funds for Waldenstrom macroglobulinemia, type 2 diabetes, and IgA nephropathy. Aside from that, we launched vitamins and supplements funds to support the nutritional needs of those affected by Alagille Syndrome and cystic fibrosis. These supplements can be very expensive, and often insurance doesn’t cover the costs.
We’re agnostic to the therapeutic area. We want to help patients in need, and we’re happy to open as many funds as our donors will support.
CL: The conditions you highlighted—like Hep C and MS—are chronic. When you’re diagnosed, it’s for the rest of your life, so HealthWell is really helping a lot of people.
There’s a significant amount of assistance available, yet we’ve seen that these resources are underutilized. How do you think technology platforms can help expand access?
AQ: It’s hard to believe, but sometimes, we have trouble programming out our funding because we don’t have enough applications. What TailorMed and other organizations can do is ensure that stakeholders know about us and the resources we provide.
TailorMed and other technology platforms are already helping by automating the screening and application process. This allows navigators to quickly see if patients qualify for assistance and improve access to available funds. Patients who come to us are under stress—financially and otherwise. By making the assistance process as easy as possible, we can be a relief point.
CL: As we look to the future, how do you think foundations and other entities can come together to tackle the pressing challenge of patient affordability?
AQ: We work with leading patient advocacy groups and national healthcare organizations—and by that, I mean our alliance partners—in a very complementary, synergistic way. We do many things very well, but we’re limited. So, we work with our partners in tandem by referring patients back and forth in areas where each of the individual organizations has strengths.
Technology and life science companies, and even providers and pharmacies, may be able to do something similar. They can assess each other’s strengths and collaborate to ensure patients get the assistance they need. In addition, I think more providers and pharmacies could use technology platforms to find available patient funding.
Affordability is a big issue. For us, we just want to help as many patients as possible access the resources that are out there to support them.
