FINANCIAL TOXICITY w/Denise Redeker

For heart transplant patients, the gift of life often comes with a hefty personal price tag. 

Financial toxicity, the large economic burden on patients and their families resulting from uninsured medical and medically related expenses, is a significant challenge faced by many transplant patients and their families. This issue is particularly pressing in Northern California, where the cost of living is incredibly high. Heartfelt Help Foundation (HHF) is at the forefront of addressing this problem, working tirelessly to "make housing happen" for heart transplant patients in financial need.

The Hidden Costs of Heart Transplants
While heart transplants can be life-saving, they also can bring substantial financial strain. For 2020, the estimated medical costs of a heart transplant in the United States before insurance totaled $1,664,800 (January 2020 Milliman Research Report). Even with insurance, patients often face significant personal costs related to their transplant, including:

• Medications 
• Travel and lodging for medical evaluations and treatments
• Copayments and Deductibles
• Temporary recovery housing for a month or longer near the transplant center (medically required, but sometimes not covered by insurance)
• Lost or reduced wages before and after the surgery

These can quickly accumulate, leading to financial distress and potentially impacting patient outcomes (UCLA Health 2024).

The Impact of Financial Toxicity
Financial toxicity can have severe consequences for heart transplant patients, including:

• Medication non-adherence, including life sustaining anti-rejection medication, due to unaffordability 
• Delayed or foregone medical care (transplant recipients require lifetime medication and medical monitoring)
• Inability to pay basic living expenses (rent, utilities, medical insurance, food, transportation)
• Debilitating stress from unrelenting worry that unaffordable necessities will result in a reduced lifespan

Studies have shown that patients with heart failure who experience financial toxicity are more likely to have worse overall health outcomes (UCLA Health 2024).

Heartfelt Help Foundation: Making a Difference
Heartfelt Help Foundation recognizes the critical need to support people in Northern California who simultaneously suffer heart failure or late stage heart disease and financial despair. Its mission is clear: When doctors require it, insurance doesn’t cover it, and patients can’t afford it, HHF can help.  HHF focuses on a crucial aspect of initial post-transplant recovery: clean, safe, private, individualized temporary recovery housing near their hospital. By providing financial aid to under-resourced patients for this core component of the transplant process, HHF alleviates a significant financial burden for transplant recipients and their families.

Strategies to Address Financial Toxicity
To combat financial toxicity for heart transplant patients, a multi-faceted approach is necessary:

1. Expand Financial Assistance Programs: Organizations like HHF (a micro nonprofit) play a vital role in providing direct financial support to patients in need.  No one else in Northern California helps heart transplant patients the way HHF does.  
2. Improve Insurance Coverage: Advocate for broader insurance coverage of medically required transplant-related expenses, including temporary recovery housing and lifelong medications.  Advocate for consumer education so they can make more informed choices when obtaining insurance and better understand their coverage.  
3. Enhance Financial Navigation Services: Provide patients with resources and guidance to navigate the complex financial landscape of transplant life.  HHF offers money management counseling free of charge.
4. Promote Shared Decision-Making: Encourage open discussions between healthcare providers and patients about medical and related costs, financial concerns and available resources to fill gaps.

Financial toxicity is a significant challenge for heart transplant patients, particularly in high cost of living areas like Northern California. Organizations like Heartfelt Help Foundation are making crucial differences in patient’s lives by directly filling their specific needs, such as for costly near hospital recovery housing. By continuing to "make housing happen" and stepping in when patients can't afford what insurance doesn't cover, HHF is helping to ensure that the gift of life through heart transplantation doesn't come at the cost of financial ruin or inability to financially support this gift of life for the rest of their lives.

As we move forward, it's essential to continue raising awareness about financial toxicity in heart transplant care and about supporting organizations that provide direct assistance to patients in need. Through collective efforts, we can work towards a future where financial concerns don't overshadow the life-saving potential of heart transplants. ∎