PLATINUM2023

Patient Advocate Foundation, Inc.

Solving Insurance and Healthcare Access Issues since 1996

aka PAF   |   Hampton, VA   |  www.patientadvocate.org

Mission

Patient Advocate Foundation was established in 1996 as a national 501(c)3 organization with a mission of “safeguarding patients through effective mediation assuring access to care, maintenance of employment and preservation of their financial stability." PAF serves as an active liaison between patients and their insurer, employer and/or creditors to resolve insurance, job retention, and/or debt crisis matters relative to their diagnosis through case managers, doctors and health care attorneys.

Ruling year info

1996

Chief Executive Officer

Dr. Alan J. Balch

President, Operations

Mrs. Fran Castellow MS.Ed.

Main address

421 Butler Farm Road

Hampton, VA 23666 USA

Show more contact info

EIN

54-1806317

NTEE code info

Alliance/Advocacy Organizations (G01)

Alliance/Advocacy Organizations (E01)

Alliance/Advocacy Organizations (H01)

IRS filing requirement

This organization is required to file an IRS Form 990 or 990-EZ.

Sign in or create an account to view Form(s) 990 for 2021, 2020 and 2019.
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Communication

Programs and results

What we aim to solve

SOURCE: Self-reported by organization

PAF professionals navigate the healthcare system on behalf of tens of thousands of patients annually, enabling them to access prescribed healthcare services and medications, overcome insurance barriers, locate resources to support cost of living expenses while in treatment, evaluate and maintain health insurance coverage and better manage, or reduce, the out-of-pocket medial debt associated with an illness.

Our programs

SOURCE: Self-reported by organization

What are the organization's current programs, how do they measure success, and who do the programs serve?

Co-Pay Relief (CPR)

In 2004, PAF opened Co-Pay Relief, a cash assistance program to provide co-payment assistance for medically and financially qualified insured patients who have prescription drug coverage but cannot pay their pharmaceutical co-pays. This premier program has been approved by the Office of the Inspector General. Visit www.copays.org for available disease funds and eligibility criteria.

Population(s) Served
Adults

PAF’s professional case management staff responds to a broad variety of patient concerns to assure access to prescribed health care while educating and empowering consumers to facilitate informed decisions and negotiate positive resolutions to issues resulting in denial of access to health care. PAF responds to patient concerns regardless of insurance status. PAF’s case management services assists with the following:
Reduce Financial Burden
• Assist in finding potential assistance with financial support: co-pay, discount and indigent drug programs, transportation, housing, food, utility shut off, negotiate payment plans with treating providers
Assist with Enrollment in Insurance and Social Programs
• Assess eligibility and assist with enrollment: Medicare/Medicaid, SCHIP, SSI and SSDI, and ACA (Marketplace/Exchange), clinical trial education, screening and enrollment, insurance plan navigation
• A baseline level of employment related support as needed (e.g., FMLA/COBRA/disability)

Population(s) Served
Adults
People with diseases and illnesses
Economically disadvantaged people

Single Donor consists of individual donors, memorial and honorarium gifts.

Events includes PAF's annual A Promise of Hope Affair fundraising event.

Population(s) Served
Adults

PAF has service agreements with other organizations, including other non-profits, to administer the operations of their program.

Population(s) Served
Adults

Where we work

Awards

Best Places to Work 2007

Inside Business

Distinguished Merit Citation 2008

Virginia Center for Inclusive Communities-Peninsula Chapter

4-Star Charity 2011

Charity Navigator

4-Star Charity 2010

Charity Navigator

4-Star Rating 2012

Charity Navigator

4-Star Rating 2013

Charity Navigator

4-Star Rating 2014

Charity Navigator

Case in Point Platinum Award for Case Management 2013

Dorland Health

Integrated Case Management Case in Point Platinum Award for PAF's MedCareLine Division 2014

Dorland Health

Case Management in Managed Care Programs-Utilization Management Case in Point Platinum Award 2015

Dorland Health

Case Management Specialty Programs: Social Work Case Management Program Case in Point Platinum Award 2015

Dorland Health

4-Star Charity 2015

Charity Navigator

4-Star Charity 2016

CharityNavigator

4-Star Charity 2017

CharityNavigator

4-Star Rating 2018

Charity Navigator

Top 100 Charities in the Nation 2018

Chronicle of Philanthropy

Top 50 Charities 2018

Insider Magazine

Top 10 Best Charities Everyone's Heard Of 2019

Charity Navigator

4-Star Charity 2019

Charity Navigator

Top 100 Charities 2019

Chronicle of Philanthropy

Top Rated NonProfit 2019

Great Non-Profits

Top 10 Best Charities Everyone's Heard Of 2019

Charity Navigator

100 out of 100 on Finance/Accountability 2020

Charity Navigator

10 Charities Expanding in a Hurry 2020

Charity Navigator

Top Rated Non-Profit 2019

Great Non-Profits

Top Rated Non-Profit 2020

Great Non-Profits

Our results

SOURCE: Self-reported by organization

How does this organization measure their results? It's a hard question but an important one.

Number of clients served

This metric is no longer tracked.
Totals By Year
Population(s) Served

Adults, Ethnic and racial groups, Social and economic status, Work status and occupations

Related Program

Case Management

Type of Metric

Output - describing our activities and reach

Direction of Success

Holding steady

Context Notes

2022 Case Management Division Case Count- 18,838; Co-Pay Relief Case Count-70,883; Financial Support Programs Case Count-81,070; Patient Services Email Helpline Session Count-116,568.

Unique Case Management Patient Issues

This metric is no longer tracked.
Totals By Year
Population(s) Served

Adults, Ethnic and racial groups, Social and economic status, Work status and occupations

Related Program

Case Management

Type of Metric

Output - describing our activities and reach

Direction of Success

Holding steady

Context Notes

2022 Case Management Issues: Insurance: 37027%; Debt Crisis/Cost of Living: 39.99%; 12.8% were uninsured. Average Contacts to Resolution per Case Management Case: 19.8. Served 1,049 disease diagnoses.

Amount of Debt Relief Obtained by Case Managers

This metric is no longer tracked.
Totals By Year
Population(s) Served

Adults, Ethnic and racial groups, Social and economic status, Work status and occupations

Related Program

Case Management

Type of Metric

Outcome - describing the effects on people or issues

Direction of Success

Increasing

Context Notes

This is the amount of debt relief obtained by PAF's case managers and includes charitable write offs, correcting coding and billing issues and identification of alternative funding sources.

Total Number of Patient Services Case Contacts

This metric is no longer tracked.
Totals By Year
Population(s) Served

Adults, Ethnic and racial groups, Social and economic status, Work status and occupations

Type of Metric

Output - describing our activities and reach

Direction of Success

Increasing

Context Notes

Total number of contacts made to the various stakeholders necessary to bring a patients case to resolution. PAF has implemented numerous technological enhancements in several programs.

Total Amount of Funds Expended to Patients

This metric is no longer tracked.
Totals By Year
Population(s) Served

Adults, Ethnic and racial groups, Social and economic status, Work status and occupations

Related Program

Co-Pay Relief (CPR)

Type of Metric

Output - describing our activities and reach

Direction of Success

Increasing

Context Notes

Funds expended to patients through PAF's Financial Support Programs Division which includes Co-Pay Relief (CPR), targeted Financial Aid Funds and other Financial Support Programs.

Goals & Strategy

SOURCE: Self-reported by organization

Learn about the organization's key goals, strategies, capabilities, and progress.

Charting impact

Four powerful questions that require reflection about what really matters - results.

To provide case management services to patients who have been diagnosed with a chronic, life-threatening or debilitating disease who have experiencing health care access issues.
To provide cash co-payment assistance to patients who qualify medically and financially.
To empower patients through provision of educational materials.

To maintain professional staff to provide case management services.
To continue to fundraise dollars from interested stakeholders for the Co-Pay Relief Program.
To create publications/webinars based on patient educational needs.

PAF’s commitment to patient services is reflected by sound fiscal practices. PAF completed its 25th year of operations on April 4, 2021 and completed its fiscal year on June 30, 2021. Charity Navigator has annually awarded PAF its highest 4-star rating for sound fiscal management. Only 2% of the charities rated have received 10 consecutive 4-star ratings. PAF has also scored 100 out of 100 on Charity Navigator’s new Encompass Ratings for Leadership and Adaptability and Financial and Accountability. Charity Navigator also recently recognized PAF as one of the “Top 10 Best Charities Everyone’s Heard Of” and as “10 Charities Expanding in a Hurry.” In addition, PAF also holds the GuideStar Platinum Seal of Transparency; the Chronicle of Philanthropy listed PAF amongst America’s top 100 charities (2017, 2018 and 2019); Insider Magazine listed PAF as one of the “Top 50 Charities” (2018); and PAF was named a Top-Rated Nonprofit by Great Nonprofits (2019, 2020, 2021). PAF is able to use 98 cents of every dollar donated to PAF to support a direct patient service program.

PAF's fiscal year is from July 1, 2021 to June 30, 2022. To date, PAF is where we expected to be from a financial standpoint.

How we listen

SOURCE: Self-reported by organization

Seeking feedback from people served makes programs more responsive and effective. Here’s how this organization is listening.

done We demonstrated a willingness to learn more by reviewing resources about feedback practice.
done We shared information about our current feedback practices.

  • How is your organization using feedback from the people you serve?

    To identify and remedy poor client service experiences, To identify bright spots and enhance positive service experiences, To make fundamental changes to our programs and/or operations, To inform the development of new programs/projects, To identify where we are less inclusive or equitable across demographic groups, To strengthen relationships with the people we serve, To understand people's needs and how we can help them achieve their goals

  • Which of the following feedback practices does your organization routinely carry out?

    We collect feedback from the people we serve at least annually, We take steps to get feedback from marginalized or under-represented people, We aim to collect feedback from as many people we serve as possible, We take steps to ensure people feel comfortable being honest with us, We look for patterns in feedback based on demographics (e.g., race, age, gender, etc.), We look for patterns in feedback based on people’s interactions with us (e.g., site, frequency of service, etc.), We act on the feedback we receive, we oftentimes will use focus groups to solicit feedback from our contituents

  • What challenges does the organization face when collecting feedback?

    We don't have any major challenges to collecting feedback

Financials

Patient Advocate Foundation, Inc.
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Operations

The people, governance practices, and partners that make the organization tick.

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Connect with nonprofit leaders

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  • Analyze a variety of pre-calculated financial metrics
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  • Compare nonprofit financials to similar organizations

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lock

Connect with nonprofit leaders

Subscribe

Build relationships with key people who manage and lead nonprofit organizations with GuideStar Pro. Try a low commitment monthly plan today.

  • Analyze a variety of pre-calculated financial metrics
  • Access beautifully interactive analysis and comparison tools
  • Compare nonprofit financials to similar organizations

Want to see how you can enhance your nonprofit research and unlock more insights? Learn More about GuideStar Pro.

Patient Advocate Foundation, Inc.

Board of directors
as of 08/29/2023
SOURCE: Self-reported by organization
Board chair

Pearl Moore

Oncology Nursing Society, (retired CEO)

Term: 2020 - 2022

Leo Sands

U.S. Oncology (Ret.)-Honorary Member

Pat Dougherty

Missouri State Senator (Ret.)-Honorary Member

Doris Simonson

Mother of Cheryl Grimmel-Honorary Member

Mary T. Christian

Virginia House of Delegates (Ret.)-Honorary Member

Sheldon Weinhaus, Esq.

Weinhaus and Postashnick-Honorary Member

Paula Trahan Rieger, RN, MSN, CAE, FAAN

Oncology Nursing Society, Former CEO

Nancy Davenport-Ennis

Patient Advocate Foundation (Retired)

John H. "Jack" Ennis

Patient Advocate Foundation (Retired)

Dr. Alan Balch

Patient Advocate Foundation-CEO

John L. Murphy

Saguenay Capital, LLC

Al Benson

Northwestern University, Feinberg School of Medicine

Edith Mitchell

Kimmell Cancer Center at Jefferson

Otis Maynard

United Healthcare

Larri Short, JD

Partner (retired) Arent Fox LLP

Rolf Binirschke

Legacy Health Strategied, Retired NFL Football Player

Maureen Culbertson

Deloitte-Government and Public Services Practices

Norman Hubbard, MBA

Office of Health Services, Michigan State University

David Jackman, MD

Dana-Farber Cancer Institute

Aaron Lyss, MBA

OneOncology

Anaeze Offocile, II, MD

University of Texas, MD Anderson Cancer Center

Daniel Press, PhD

Santa Clara University, California

Gabrielle Rocque, MD

University of Alabama-Birmingham

Veena Shankaran, MD

University of Washington, Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance

Reginald Tucker-Seeley, MA, ScM, ScD

University of Southern California

David White

Dreyfus Health Policy and Research Center

Deborah Parham Hopson, PhD

Maya Tech Corporation

Board leadership practices

SOURCE: Self-reported by organization

GuideStar worked with BoardSource, the national leader in nonprofit board leadership and governance, to create this section.

  • Board orientation and education
    Does the board conduct a formal orientation for new board members and require all board members to sign a written agreement regarding their roles, responsibilities, and expectations? Yes
  • CEO oversight
    Has the board conducted a formal, written assessment of the chief executive within the past year ? Yes
  • Ethics and transparency
    Have the board and senior staff reviewed the conflict-of-interest policy and completed and signed disclosure statements in the past year? Yes
  • Board composition
    Does the board ensure an inclusive board member recruitment process that results in diversity of thought and leadership? Yes
  • Board performance
    Has the board conducted a formal, written self-assessment of its performance within the past three years? Yes

Organizational demographics

SOURCE: Self-reported; last updated 2/21/2023
info Candid has made improvements to the race and ethnicity options.

Who works and leads organizations that serve our diverse communities? Candid partnered with CHANGE Philanthropy on this demographic section.

Leadership

The organization's leader identifies as:

Race & ethnicity
White/Caucasian/European
Gender identity
Male
Sexual orientation
Heterosexual or straight
Disability status
Person without a disability

The organization's co-leader identifies as:

Race & ethnicity
White/Caucasian/European
Gender identity
Female
Sexual orientation
Heterosexual or straight

Race & ethnicity

Gender identity

 

Sexual orientation

Disability

Equity strategies

Last updated: 08/29/2023

GuideStar partnered with Equity in the Center - an organization that works to shift mindsets, practices, and systems to increase racial equity - to create this section. Learn more

Data
  • We review compensation data across the organization (and by staff levels) to identify disparities by race.
  • We ask team members to identify racial disparities in their programs and / or portfolios.
  • We analyze disaggregated data and root causes of race disparities that impact the organization's programs, portfolios, and the populations served.
  • We disaggregate data to adjust programming goals to keep pace with changing needs of the communities we support.
  • We employ non-traditional ways of gathering feedback on programs and trainings, which may include interviews, roundtables, and external reviews with/by community stakeholders.
  • We disaggregate data by demographics, including race, in every policy and program measured.
  • We have long-term strategic plans and measurable goals for creating a culture such that one’s race identity has no influence on how they fare within the organization.
Policies and processes
  • We have a promotion process that anticipates and mitigates implicit and explicit biases about people of color serving in leadership positions.
  • We seek individuals from various race backgrounds for board and executive director/CEO positions within our organization.
  • We have community representation at the board level, either on the board itself or through a community advisory board.
  • We help senior leadership understand how to be inclusive leaders with learning approaches that emphasize reflection, iteration, and adaptability.
  • We measure and then disaggregate job satisfaction and retention data by race, function, level, and/or team.
  • We engage everyone, from the board to staff levels of the organization, in race equity work and ensure that individuals understand their roles in creating culture such that one’s race identity has no influence on how they fare within the organization.