Financial Navigation Roles and Responsibilities and the Effects of COVID-19

November 2020 Vol 11, No 11
Clara Lambert, CPH, BBA, OPN-CG
Director of Financial Navigation
Christie H. Lee, BA
New York, NY

Background: The first cases of COVID-19 in the United States were reported in early January 2020 and began rapidly increasing in March 2020. The ensuing pandemic greatly impacted the healthcare industry and patients as it caused greater economic needs for patients while simultaneously hindering access to medical services. As provider organizations have adjusted to the new environment, financial navigators have continued to provide vital services for patients who rely on them to gain access to treatments. These services are defined as providing access to external assistance programs in combination with insurance optimization.

Objectives: The objective of the research is to understand the roles and responsibilities that financial navigators play in their organizations, and the impact that COVID-19 has had on their ability to provide financial navigation support.

Methods: Quantitative research through an anonymous survey was conducted. The survey was disseminated to professional organizations and networks of financial navigators through social media. The survey covered respondent demographics, job title, responsibilities, employer type and size, team size, and the impact of COVID-19 on their team and ability to provide services to patients.

Results: There were 21 respondents, 14 of whom identified as financial navigators (FNs). Most FNs reported to Cancer Support Services (57%). The remaining FNs reported to the Pharmacy (29%) or Patient Accounts/Revenue Cycle departments (14%). Most teams with 1 to 2 FNs supported 1 to 30 new patients per month. Teams with 3 to 5 FNs supported 1 to 40 new patients per month, and teams with 6 to 10 FNs supported 11 to 50 new patients per month. The majority of FNs reported reviewing and enrolling patients into assistance programs (93%), insurance review and optimization (86%), out-of-pocket estimation (71%), copay assistance billing (71%), insurance verification (64%), benefits investigation (64%), and free medication ordering (64%) as part of their responsibilities.

The majority of FNs reported that COVID-19 had impacted their organization’s ability to provide financial navigation services (71%). Of those FNs, 70% reported they or their team provided financial navigation through phone or video conference, and 60% experienced furlough or hour reductions. Thirty-six percent of FNs responded they supported fewer patients from March to July 2020 than in the same period last year, and of these respondents, 100% responded they or their team were working from home and tended to be on teams of 1 to 5 FNs. Thirty-six percent of FNs responded that they supported more patients, and of these respondents, 80% responded they or their team were working from home and/or experienced furlough and tended to be on teams of 6 to 10 FNs.

Conclusions: Financial navigators play a crucial role in assisting patients in their care journey, and the COVID-19 pandemic has further highlighted the necessity of this role. During the pandemic, many FNs experienced changes to their work environment, such as working from home, reduced hours, and reduced workforce. Despite these obstacles, they were still able to support patients, and some teams, such as larger teams and pharmacy departments, were able to support even more patients throughout the pandemic. Future research should focus on the reasons why larger teams and pharmacy departments were able to assist more patients.


Centers for Disease Control and Prevention. United States COVID-19 Cases and Deaths by State.

American Cancer Society. COVID-19 Pandemic Impact on Cancer Patients and Survivors. Survey Findings Summary. ing%20Memo.Final_.pdf. 2020.

Sherman D, Fessele KL. Financial support models: a case for the use of financial navigators in the oncology setting. Clin J Oncol Nurs. 2019;23:14-18.

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