Patient Advocate Foundation Inc

PATIENT ADVOCATE FOUNDATION (PAF) IS A NATIONAL 501 (C)(3) NON-PROFIT ORGANIZATION THAT PROVIDES PROFESSIONAL CASE MANAGEMENT AND FINANCIAL AID ASSISTANCE TO AMERICANS WITH CHRONIC, LIFE THREATENING AND DEBILITATING ILLNESSES. PAF CASE MANAGERS SERVE AS ACTIVE LIAISONS BETWEEN THE PATIENT AND THEIR INSURER, EMPLOYER AND/OR CREDITORS TO RESOLVE INSURANCE, JOB RETENTION AND/OR DEBT CRISIS MATTERS AS THEY RELATE TO THEIR DIAGNOSIS. PATIENT ADVOCATE FOUNDATION SEEKS TO SAFEGUARD PATIENTS THROUGH EFFECTIVE MEDIATION ASSURING ACCESS TO CARE, MAINTENANCE OF EMPLOYMENT AND PRESERVATION OF THEIR FINANCIAL STABILITY.

FINANCIAL SUPPORT PROGRAMSFOR OVER 20 YEARS, PAF'S CO-PAY RELIEF PROGRAM (CPR) HAS PROVIDED FINANCIAL ASSISTANCE FOR CO-PAYMENTS, CO-INSURANCE AND DEDUCTIBLES REQUIRED BY A PATIENT'S INSURER FOR MEDICATIONS PRESCRIBED TO TREAT AND/OR MANAGE THE PATIENT'S DISEASE.IN FY 2023/2024 PAF'S CO-PAY RELIEF PROGRAM EXPANDED ITS IMPACT THROUGH THE ADDITION OF FOUR (4) NEW GENERAL FUNDS, ASSISTING PATIENTS IN FIVE (5) NEW HEALTH EQUITY (HE) FUNDS AND FORTY-NINE (49) EXISTING FUNDS INCLUDING:ACROMEGALY, ACUTE MYELOID LEUKEMIA, ALZHEIMER'S DISEASE HE, AMYLOIDOSIS, ASTHMA, BILE DUCT CANCER, BREAST CANCER, BREAST CANCER HE, CANCER GENETIC & GENOMIC TESTING, CERVICAL CANCER, CHRONIC OBSTRUCTIVE PULMONARY DISEASE HE, CORONARY ARTERY DISEASE HE, COVID-19 & POST COVID CONDITIONS, CYSTIC FIBROSIS, DIABETES, DIABETES HE, DIABETES TYPE 2 HE, GAUCHER DISEASE, GAUCHER DISEASE HE, HEART FAILURE HE, HEMOPHILIA, HEPATITIS B, HEPATITIS C HE, HEPATOCELLULAR CARCINOMA, HIV, AIDS & PREVENTION, HIV, AIDS & PREVENTION HE, HOMOZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA, LUPUS, LUPUS HE, MELANOMA, METASTATIC BREAST CANCER, METASTATIC COLORECTAL CANCER, METASTATIC COLORECTAL CANCER HE, METASTATIC PROSTATE CANCER, MULTIPLE MYELOMA, MULTIPLE MYELOMA HE, MULTIPLE SCLEROSIS, MULTIPLE SCLEROSIS HE, MYELODYSPLASTIC SYNDROMES, NON-SMALL CELL LUNG CANCERS, NON-SMALL CELL LUNG CANCERS HE, OVARIAN CANCER, OVARIAN CANCER HE, PANCREATIC CANCER, PARKINSON'S DISEASE HE, PERIODIC PARALYSIS, PROSTATE CANCER, PROSTATE CANCER HE, PULMONARY FIBROSIS, PULMONARY HYPERTENSION, RENAL CELL CARCINOMA, RHEUMATOID ARTHRITIS, SMALL CELL LUNG CANCER, SOCIAL NEEDS ASSESSMENT & INTERVENTION FUND, SPINAL MUSCULAR ATROPHY, SPINAL MUSCULAR ATROPHY HE, THYROID EYE DISEASE AND VIROLOGY TESTING HE.PAF'S CO-PAY RELIEF PROGRAM ESTABLISHED HEALTH EQUITY FUNDS IN 2022, A NEW TYPE OF FUND THAT MAKES CPR MORE ACCESSIBLE AND BENEFICIAL FOR PATIENTS WHO NEEDED THE MOST HELP AND ARE NOT BEING SERVED ADEQUATELY BY THE EXISTING MEDICAL AND COPAY INFRASTRUCTURE. DEVELOPED USING THE CDC'S SOCIAL VULNERABILITY INDEX (SVI) AND CDC DISEASE INCIDENCE DATA, OUR HEALTH EQUITY FUNDS SERVE PEOPLE LIVING IN 220 COUNTIES ACROSS THE UNITED STATES THAT HAVE BEEN IDENTIFIED BY THE CDC AS HAVING THE HIGHEST SOCIAL VULNERABILITY SCORES AND ARE BURDENED WITH HIGH RATES OF CHRONIC DISEASES. THE HEALTH EQUITY FUNDS ARE DESIGNED TO SPECIFICALLY PROVIDE SUPPORT TO ELIGIBLE PATIENTS LIVING IN ONE OF THE 220 COUNTIES COVERED BY THE FUNDS, WHICH IS VERIFIED USING THE ZIP CODE OF THE PATIENT'S HOME ADDRESS. ALL OTHER ELIGIBILITY REQUIREMENTS, AND FUND OPERATION, ARE THE SAME AS OUR GENERAL FUNDS. IN FY2023/2024, ESTABLISHED FIVE (5) NEW HEALTH EQUITY FUNDS INCLUDING: GAUCHER DISEASE HE, LUPUS HE, MULTIPLE SCLEROSIS HE, SPINAL MUSCULAR ATROPHY HE AND DIABETES TYPE 2 HE. PAF HAS PROVIDED NEARLY 10,000 PATIENTS WITH ASSISTANCE THROUGH THE HE FUNDS.THE FOUNDATION'S CO-PAY RELIEF PROGRAM OFFERS A DEDICATED, SECURE WEB-BASED APPLICATION FOR PATIENTS AND/OR THEIR FAMILY MEMBERS TO ENROLL ELECTRONICALLY FOR THE CO-PAY RELIEF PROGRAM DIRECTLY FROM THE CO-PAY RELIEF PROGRAM WEBSITE. AS WELL, CPR OFFERS TWO DEDICATED, SECURED WEBSITES FOR MEDICAL PROVIDERS AND PHARMACY REPRESENTATIVES TO ENROLL ELECTRONICALLY FOR THE CO-PAY RELIEF PROGRAM ON BEHALF OF THE PATIENTS THEY ARE WORKING WITH. THE FOUNDATION ALSO OFFERS TELEPHONIC SUPPORT SERVICES TO PATIENTS WHO PREFER TO RECEIVE PERSONAL ASSISTANCE FROM A PROGRAM SPECIALIST.IN FY2023/2024, THE FOUNDATION ADMINISTERED CO-PAYMENT ASSISTANCE TO 75,629 QUALIFIED PATIENTS THROUGH 58 ASSISTANCE FUNDS AVAILABLE THROUGH THE CO-PAY RELIEF PROGRAM. THE PROGRAM STAFF FIELDED 194,142 TELEPHONE CALLS AND PROCESSED CLAIMS TOTALING OVER $243,377,348 IN SUPPORT OF QUALIFIED PATIENTS' OUT OF POCKET EXPENSES FOR REQUIRED CO-PAYMENTS, CO-INSURANCE, AND DEDUCTIBLES. SINCE ITS INCEPTION IN 2004, THE FOUNDATION HAS PROVIDED CO-PAYMENT ASSISTANCE TO OVER 753,000 INDIVIDUALS ALLOCATING $2.4 BILLION DOLLARS IN CO-PAYMENT AWARDS.PAF ALSO ADMINISTERED A SUITE OF FIFTEEN (15) SMALL GRANT PROGRAMS IN FY2023/2024 REFERRED TO AS FINANCIAL AID FUNDS, EACH PROVIDING FINANCIAL ASSISTANCE TO QUALIFIED PATIENTS FOR OUT OF POCKET AND COST OF LIVING EXPENSES PATIENTS STRUGGLE TO MANAGE WHEN DEALING WITH A CHRONIC OR CRITICAL DISEASE. IN FY2023/2024, PROGRAM STAFF FIELDED 21,111 TELEPHONE CALLS AND SUCCESSFULLY PROVIDED ONE-TIME SMALL GRANTS TO 2,445 PATIENTS, TOTALING $5,158,800 IN FINANCIAL RELIEF. THE SMALL GRANTS RANGE FROM $500-$4500 PER PATIENT AND ARE DESIGNED TO DEFRAY NON-MEDICAL EXPENSES, INCLUDING TRANSPORTATION, LODGING, NUTRITIONAL NEEDS, CHILDCARE AND BURIAL EXPENSES, FACED BY PATIENTS BECAUSE OF THEIR DIAGNOSIS AND TREATMENT. THE FINANCIAL AID FUND PROGRAMS INCLUDE: ARDS ALLIANCE SUMITA DIXIT RECOVERY FUND: SERVING PATIENTS DIAGNOSED WITH ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS). BEGIN AGAIN FOUNDATION AMPUTEE FUND: SERVING PATIENTS DIAGNOSED WITH SEPSIS WHO HAVE EXPERIENCED AN AMPUTATION AS A RESULT SEPSIS. BEGIN AGAIN FOUNDATION BEREAVEMENT FUND: SUPPORTS FUNERAL EXPENSES ASSOCIATED WITH PATIENTS WHO HAVE PASSED AND DIED FROM ARDS, TSS AND/OR SEPSIS. BEGIN AGAIN FOUNDATION FINANCIAL AID FUND: SERVING PATIENTS DIAGNOSED WITH ARDS, TSS AND/OR SEPSIS. BEGIN AGAIN FOUNDATION SOUTHEASTERN VIRGINA FINANCIAL AID FUND: SERVING PATIENTS DIAGNOSED WITH ARDS, TSS AND/OR SEPSIS THAT RESIDE IN SOUTHEASTERN VIRGINIA. CASE MANAGEMENT IMMEDIATE NEED FUND: SERVING PATIENTS WITH AN IMMEDIATE NEED TO COVER THE OUT-OF-POCKET EXPENSES ASSOCIATED WITH COST-OF-LIVING EXPENSES RELATED TO TREATMENTS. DONNA FINANCIAL AID FUND: SERVING PATIENTS DIAGNOSED WITH BREAST CANCER THAT HAVE RECEIVED CASE MANAGEMENT SERVICES THROUGH THE DONNA CARELINE. HEART VALVE FINANCIAL AID FUND: SERVING PATIENTS DIAGNOSED WITH A HEART VALVE CONDITION. MERKEL CELL CARCINOMA FINANCIAL AID FUND: SERVING PATIENTS DIAGNOSED WITH A RARE FORM OF SKIN CANCER. MIA'S MIRACLES: SERVING PEDIATRIC PATIENTS DIAGNOSED WITH BRAIN CANCER. NATIONAL OVARIAN CANCER COALITION CLINICAL TRAIL FUND: SERVING PATIENTS THAT HAVE BEEN DIAGNOSED WITH OVARIAN CANCER, FALLOPIAN TUBE CANCER OR PERITONEAL CANCER AND ARE PARTICIPATING IN A CLINICAL TRIAL, BY PROVIDING FINANCIAL ASSISTANCE FOR COST-OF-LIVING EXPENSES. NATIONAL OVARIAN CANCER COALITION TREATMENT FUND: SERVING PATIENTS THAT HAVE BEEN DIAGNOSED WITH OVARIAN CANCER, FALLOPIAN TUBE CANCER OR PERITONEAL CANCER, BY PROVIDING FINANCIAL ASSISTANCE FOR COST-OF-LIVING EXPENSES. OKLAHOMA TRANSPORTATION FINANCIAL AID FUND: SERVING PATIENTS THAT HAVE BEEN DIAGNOSED WITH PROSTATE CANCER AND RESIDE IN OKLAHOMA. THE PEDIATRIC AMINO ACID & METABOLIC FORMULAS EMERGENCY ASSISTANCE FUND: SERVING FAMILIES WHO HAVE EXPERIENCED UNEXPECTED COSTS RELATED TO AN IN-PATIENT HOSPITALIZATION OR EMERGENCY ROOM VISIT OF A CHILD WHO IS RELIANT ON AMINO ACID-BASED OR METABOLIC BASED FORMULAS FOR NUTRITION. THYROID EYE DISEASE: SUPPORTS PATIENTS WHO ARE BEING EVALUATED, UNDERGOING TREATMENT, OR RECEIVING FOLLOW UP CARE FOR PROSTATE CANCER. IN FY2022/2023, 1,641 PATIENTS RECEIVED FINANCIAL RELIEF FROM SIXTEEN (16) FINANCIAL FUNDS, TOTALING $2,267,500.

NON-PROFIT SERVICE AGREEMENTSIN 2009, THE FOUNDATION ENTERED INTO A TRANSPARENT SERVICE ADMINISTRATION AGREEMENT WITH A NATIONAL NONPROFIT ORGANIZATION. THE FOUNDATION HAS BEEN ENGAGED TO PROVIDE FULL SERVICE, TRANSPARENT ADMINISTRATION SERVICES TO QUALIFIED PATIENTS THAT ENTER THEIR CO-PAY ASSISTANCE AND PATIENT FINANCIAL AID PROGRAMS. THE FOUNDATION CONTINUED TO PROVIDE THIS CONTRACTUAL SERVICE DURING 2024 AND 2023. THE FOUNDATION ADMINISTERED SERVICES TO 70,982 AND 69,619 PATIENTS IN 2024 AND 2023, RESPECTIVELY, THROUGH THIS SERVICE AGREEMENT.

CASE MANAGEMENT SERVICESFOR 28 YEARS, THE FOUNDATION HAS PROVIDED CASE MANAGEMENT INTERVENTIONS FOR CRITICALLY OR CHRONICALLY ILL PATIENTS ACROSS THE NATION. OUR MISSION IS TO HELP PATIENTS CONNECT WITH AND MAINTAIN ACCESS TO PRESCRIBED HEALTHCARE SERVICES AND MEDICATIONS, NAVIGATE INSURANCE BARRIERS, FIND RESOURCES TO SUPPORT COST-OF-LIVING EXPENSES DURING TREATMENT, EVALUATE AND SUSTAIN HEALTH INSURANCE COVERAGE, AND MANAGE OR REDUCE OUT-OF-POCKET MEDICAL AND LIVING EXPENSES.PAF'S PROFESSIONAL CASE MANAGEMENT SERVICES ARE OFFERED AT NO COST TO PATIENTS AND THEIR FAMILIES. WE COLLABORATE CLOSELY WITH PATIENTS, THEIR LOVED ONES, AND THEIR CARE TEAMS, OFTEN TAKING THE LEAD IN RESOLVING COMPLEX HEALTHCARE ACCESS AND AFFORDABILITY CHALLENGES. IN FY23/24, THE FOUNDATION'S CASE MANAGEMENT STAFF DIRECTLY ASSISTED OR ADVOCATED FOR 14,028 INDIVIDUALS, COLLECTIVELY LIVING WITH 635 UNIQUE DISEASES. ON AVERAGE, EACH CASE INVOLVED 30 CONTACTS WITH RELEVANT STAKEHOLDERS TO ACHIEVE RESOLUTION, TOTALING 425,825 UNIQUE INTERACTIONS. THE AVERAGE CONTACTS PER CASE INCREASED 20% OVER FY23/24. THIS EFFORT RESULTED IN AN AVERAGE DEBT RELIEF OR PATIENT SAVINGS OF $1,294 PER CASE.IN ADDITION TO THESE SERVICES, PAF DISTRIBUTED 2,542 EDUCATIONAL PUBLICATIONS TO PATIENTS AND THOSE SEEKING INFORMATION. THE FOUNDATION OPERATES A DIVERSE PORTFOLIO OF 27 UNIQUE CASE MANAGEMENT PROGRAMS, EACH DESIGNED TO SUPPORT PATIENTS IN THEIR HEALTHCARE JOURNEYS, WORKING TO RESOLVE ACCESS AND AFFORDABILITY ISSUES THAT, IF NOT ADDRESSED, IMPACT CARE AND HEALTH OUTCOMES.