Treatment RFA Patient Care Costs

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Treatment RFA Patient Care Costs

Post  hthurston on Thu Oct 23, 2014 11:16 am

Please provide more specifics on level of detail for patient care costs by procedure in Treatment applications. If the target population is under/uninsured, a stage of diagnosis come with multiple and varied treatment procedures. What is the expectation for including and projecting expenses when there are so many variables in patient expenses? Thank you.

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guidance - treatment costs

Post  Admin on Sun Nov 02, 2014 8:03 am

The intent in asking for CPT codes by treatment regimen is to provide more education for grant reviewers to understand why you are asking for the amount you are asking for to serve your target patient population. Grant reviewers are not necessarily experts in cancer treatment costs, and most likely are not experts in how costs vary according to prescribed treatment regimens based on stage and cancer subtype. The affiliate understands that actual costs will vary because you don't know what stage and type of breast cancer diagnosis will need to be treated using Komen funding; however, the expectation in the grant application is that you use past patient diagnoses and, if available, prior utilization of Komen grant funds, to explain how you are determining per-patient caps and/or estimates to treat someone diagnosed as Stage II HER2+. In some instances, CPT codes may not be the most appropriate way to justify the expenses for your budget; in that case, some other narrative that explains how you calculated your request for funding should be provided. 

Overall, because the Affiliate does not expect any treatment grant to cover 100% of costs for Komen-eligible patients, please maximize the project budget summary page to better reflect what proportion of breast cancer treatment expenses Komen grant funding supports vs the overall cost to treat Komen-eligible patients. The project budget summary page is the best tool in GeMS to reflect your organizations' in-kind/write-off contributions for Komen-eligible patients.

Note: The Affiliate would not be surprised if projected treatment expenses generally reflect later-stage diagnoses because the patient population that tends to be Komen-eligible is medically underserved and may not have a regular history of screenings.
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