A new study in JAMA Oncology shows that cancer survivors in Massachusetts continue to face modest but persistent levels of medical debt in collections for years after diagnosis, even with near-universal insurance coverage.
Why it matters: Cancer is one of the costliest conditions for patients, and financial toxicity has long been recognized as a side effect of treatment.
Even small amounts of debt in collections can harm a patient’s credit score, increase the likelihood of lawsuits, and restrict access to housing, loans, and jobs.
For healthcare providers and revenue cycle leaders, the study highlights the long tail of financial strain following diagnosis — and the reputational and operational risks tied to medical debt.
By the numbers:
- Researchers analyzed records from 74,146 patients with cancer and matched them with a control group of the same size between 2010 and 2019.
- Medical debt in collections rose $15.45 on average for cancer survivors compared to controls, persisting more than six years after diagnosis.
Subgroup findings:
- Colorectal cancer patients: +$155.55 in collections after six years.
- Bladder cancer patients: +$375.77 in collections after 5.5 years.
No significant differences were found in total debt, overall debt in collections, bankruptcy rates, or credit scores between patients and controls.
What they’re saying: “For some people $300 might not be a big deal, but $300 for somebody else may be a bill they can’t pay,” said lead author Benjamin James, MD, of Beth Israel Deaconess Medical Center. “We care less about the dollar amount than the overall impact of money going to collections.”
“This study really showed that while we don’t see a massive amount of debt, it lingers for many years,” James added.
Fumiko Chino, MD, of MD Anderson Cancer Center, noted that the relatively small debt levels may reflect Massachusetts’ strong insurance coverage and anti-poverty policies, cautioning that results could look “drastically worse” in states with higher uninsured rates.
The big picture
