Various studies have examined how early retirement and reduced retirement contributions, both voluntarily and involuntarily, have affected workers, in general, due to COVID-19. This paper discusses and highlights specific financial impacts for employees due to early retirement. Evaluations based on standard actuarial methods are described and quantitatively presented. These evaluations show that early retirement has a more severe impact on older age employees. As expected, early retirement has a higher retirement income reduction for those with a high salary-asset ratio, since early retirement reduces the overall contribution to the retirement plan. Furthermore, we show that a reduced contribution overall impacts the retirement annual income uniformly regardless of age, and it more severely impacts those who plan to work longer than those who plan to retire soon. We also found that early retirement has a similar reduction impact on both fixed dollar amount contribution and fixed percentage of salary contribution mechanisms.

Background: Indonesia’s National Health Insurance system has introduced the Standardized Inpatient Class policy to reduce service disparities and improve equity and quality of inpatient care. However, compliance with standardized inpatient requirements entails substantial infrastructure and operational costs that may affect hospital financial performance. Purpose: To systematically examine how the implementation of the Standardized Inpatient Class policy influences hospital financial performance in Indonesia. Method: A systematic literature review was conducted following the PRISMA 2020 guidelines. Articles published between 2014 and 2025 were identified from Scopus, PubMed, and Google Scholar using predefined keywords related to standardized inpatient care, health financing, and hospital performance. Quality appraisal was conducted using the Joanna Briggs Institute (JBI) Critical Appraisal Tools. Eligible studies were screened using inclusion and exclusion criteria and synthesized using narrative thematic analysis. Results: Twelve studies met the inclusion criteria. The findings indicate that Standardized Inpatient Class implementation increases capital investment and operational costs, reduces bed capacity in some hospitals, and creates mismatches between reimbursement rates and actual service costs. Financial impacts vary by hospital ownership and location, with public and rural hospitals experiencing greater financial strain. Conclusion: While the Standardized Inpatient Class policy promotes equity and service quality, its implementation poses significant financial challenges for hospitals. Policy refinement, reimbursement adjustment, and targeted financial support are essential to ensure hospital financial sustainability.

Overseas large-scale combat operations (LSCOs) could require domestic hospitals to treat large numbers of combat casualties. Our goal was to evaluate the financial impact on hospitals of treating combat casualties during an LSCO. Using a discrete event simulation model, we explored how 5 civilian hospitals in Omaha, Nebraska, would fare after accepting combat casualties during a National Disaster Medical System (NDMS) activation. We compared changes in financial measures (government payments, hospital revenues) and occupancy measures (civilian patient displacement) under different scenarios for combat casualty reimbursement rates as fractions (75%-125%) of Medicare rates. Combat casualties replaced 100% of civilian patients at 3 of 5 hospitals, displacing a total of 10,905 civilian patients [95% CI: 10551-11248]. Combat casualty reimbursement at 125% of Medicare rates resulted in government payments of $462 million and net income gains for civilian hospitals of approximately 23 times pre-activation baselines. Combat casualty reimbursement below 125% of Medicare rates led to net income losses. Large influxes of combat casualties could result in rapid, profound displacement of civilian patients and revenue loss at NDMS-participating facilities, potentially affecting hospitals' ability and willingness to treat them. Policymakers need to identify appropriate reimbursement rates for combat casualties.

In 1995, Medicare reduced payments by 50% for anesthesiologists teaching two residents concurrently. By 2004, anesthesiology residency programs were losing, on average, $400,000 per year, causing many institutions to close their anesthesiology training programs. American Society of Anesthesiologists leaders tried unsuccessfully for several years to address this situation through appeals to Medicare. They then organized an advocacy effort to pass the Medicare Anesthesiology Teaching Funding Restoration Act of 2007, which in 2010 restored full payments for teaching anesthetics. From 2010 through 2024, anesthesiologists received $1.262 billion from Medicare for 2.8 million cases involving residents, which is between $442 million and $568 million more than if the legislation had not been enacted. Anesthesiology residency programs increased from 131 to 167 after the enactment. This historic legislation taught anesthesiologists that changing Medicare policies may require congressional action and that persistent and broad-based advocacy can make a legislative campaign successful.

This study examines the environmental implications of energy-intensive cryptocurrency mining activities within the broader sustainability debate surrounding blockchain technologies. Focusing specifically on Bitcoin’s proof-of-work–based mining process, the analysis investigates the long-run relationship between greenhouse gas emissions, network-specific technical variables, and climate policy uncertainty using advanced cointegration and asymmetric causality techniques. The findings reveal a stable long-run association between mining-related activity and emissions, alongside pronounced asymmetries whereby positive shocks amplify environmental pressures more strongly than negative shocks mitigate them. Importantly, these results pertain to the mining process itself rather than to blockchain technology as a whole. While blockchain infrastructures may support sustainable applications in areas such as green finance, transparency, and energy management, the evidence presented here highlights that energy-intensive mining remains a significant environmental concern. Accordingly, the study underscores the need for active regulatory frameworks—such as carbon pricing and the polluter-pays principle—to reconcile the environmental costs of crypto mining with the broader sustainability potential of blockchain-based innovations

In recent years, the scale of enterprise mergers and acquisitions in China has continued to grow, but the failure rate of integration remains high. Cultural conflicts and strategic disconnections often lead to "similarity in appearance but not in essence" in mergers and acquisitions. Currently, there are relatively few research cases on the failure of mergers and acquisitions, and insufficient attention is paid to the financing and integration processes as well as their outcomes. It is challenging to identify the key factors that influence integration failure. Therefore, further exploration is urgently needed. This article selects the typical case of Guangdong Hongda Blasting Co., Ltd's Acquisition of Xinjiang Xuefeng Sci-Tech (group) Co., Ltd (the integration failed). By combining the financial data of the case enterprise one year before and after the acquisition, this study adopts a 'short-term-long-term' dual-dimensional analysis method to sort out the integration process and its impact on market results, and analyzes the influence of various data factors on the success or failure of the integration. The research conclusion of this article not only enriches empirical evidence in the field of acquisition performance but also provides practical references for enterprises to formulate acquisition strategies, and at the same time provides a decision-making basis for regulatory authorities to guide rational acquisitions.

Method - Utilizes a qualitative approach with secondary data analysis from financial records, NGO reports, and regional socio-economic indicators. Key Findings - The project exhibited financial transparency, but gaps in report consolidation, income tracking, and variance analysis were identified. Social benefits, such as improved income and community resilience, were observed, though not monetarily quantified. Environmental metrics, including ecosystem service valuation and sustainability indicators, were absent. Theoretical and Policy Implications - Highlights the need for structured accounting practices, including SROI and cost-benefit analysis, to enhance sustainability, transparency, and stakeholder engagement in local environmental projects. Research Novelty – This study provides a new perspective on how environmental accounting can integrate financial, social, and ecological evaluations in peatland restoration projects at the village level, while emphasizing its crucial role in supporting sustainable ecosystem management.

Geomagnetic disturbances are an emerging sustainability challenge for modern, low-carbon and highly interconnected power systems, affecting both grid stability and market performance. We develop a deep causal neural network that fuses geomagnetic observatory measurements with national operational indicators and, via counterfactual inference, traces shock and no-shock trajectories to estimate instantaneous and cumulative impacts. Using Switzerland as a case, shocks significantly change national load, canton-level consumption, cross-border flows, and balancing prices. East–west disturbances have stronger effects than north–south, highlighting the role of grid topology. At the regional scale, the canton of Aargau shows pronounced cumulative consumption responses, revealing spatial heterogeneity. In cross-border exchanges, imports rise after shocks while exports contract and transit flows decline; balancing prices increase markedly, suggesting that market mechanisms can amplify physical stress into economic impacts. The approach goes beyond correlation and exposure metrics by providing system-level, decision-relevant effect sizes. The main contributions are as follows: (i) a deep causal framework that identifies and quantifies the causal effects of geomagnetic disturbances on grid operations and prices; (ii) topology-linked empirical evidence of directional and spatial asymmetries across national, canton-level, and cross-border indicators; and (iii) actionable levers for system operation and market design. These findings inform risk-aware reserve procurement, topology-aware dispatch, and cross-border coordination in highly interconnected, low-carbon grids, helping to enhance reliability, maintain affordability, and facilitate clean-energy integration.

Abstract As in the 2020 Caregiving in the US survey, one in five family caregivers experienced high financial strain due to their caregiving responsibilities. This strain may result from out-of-pocket care costs, reduced work hours, or a combination of factors. The 2025 Caregiving in the US report provides a detailed look at the financial impacts that family caregivers experience. Caregivers report a range of financial impacts, including debt, savings, and housing-related issues. Lower-income family caregivers (those with less than $50,000 in household income) are significantly more likely to experience all thirteen financial impacts identified in the survey. Younger caregivers also face more financial challenges due to caregiving. Both groups often start their caregiving journey with fewer savings and assets, making them more vulnerable to long-term financial insecurity. This presentation will summarize the financial strain and impact measures reported by caregivers in 2025 and highlight the groups most likely to experience financial pressures. Caregivers overwhelmingly support policy solutions such as caregiver income tax credits, paid family leave, and programs to pay family caregivers for their care. Understanding both the overall financial pressures and the caregivers hardest hit is critical to developing effective policy solutions to support all caregivers financially.

Abstract Every five years, the National Alliance for Caregiving and AARP’s Caregiving in the US (CGUS) survey provides a snapshot of family caregivers, their care recipients, care tasks, help with caregiving, supports received in health systems, and the work and financial impacts of caregiving. This symposium presents emerging themes from the 2025 CGUS survey and highlights actionable policy and practice solutions in each area. Family caregivers are now providing help with more activities of daily living and instrumental activities of daily living than in the past, yet few receive training on how to perform these tasks. Presenters 1 and 2 discuss these findings and the Caregiver Training Services (CTS) Codes introduced for Medicare providers in 2024. They share qualitative work examining provider experiences supporting caregivers in health systems and offer a practical guide for using the new CTS codes. Caregivers report greater availability of supportive workplace policies but continue to struggle balancing work and care responsibilities. Presenter 3 overviews these new findings and caregivers’ ongoing struggle to balance work and care responsibilities despite increased support at work. While many caregivers experience financial pressures due to caregiving, certain groups disproportionately face these challenges. Presenter 4 summarizes the financial impact of caregiving, focusing on younger caregivers and other groups most affected by financial impacts. Presenters 3 and 4 highlight progress in introducing policies to support working caregivers and innovative new policy solutions to support caregivers financially. Presenter 5 shares the newest innovation in CGUS: state-level data on caregivers and their experiences.

Abstract Unpaid caregivers provide an essential yet often unrecognized economic foundation for the U.S. healthcare and long-term care systems. Valued at over billions of dollars annually, their contributions surpass Medicaid’s total spending on long-term services and supports. Yet, despite their critical role, caregivers frequently face financial and employment barriers that jeopardize their own well-being. Many reduce work hours, leave the workforce, or forgo career advancement—decisions that come with steep costs, including lost wages, reduced retirement savings, and diminished Social Security benefits. These barriers disproportionately impact women, low-income caregivers, and historically underrepresented racial and ethnic groups, further widening economic and health disparities. This symposium examines the financial, employment, and health implications of caregiving across diverse populations. The first presentation explores the relationship between intergenerational financial support and planned retirement timing among middle-aged and older workers. Using experimental methods, the second presentation investigates and uncovers hiring bias toward family caregivers, finding that hiring penalties for caregivers to older adults may be even greater than hiring penalties toward parents The third presentation quantifies the opportunity cost of family caregiving, estimating lost income, retirement savings, and Social Security benefits for those reducing work hours or leaving the workforce. Using AARP’s latest data and the Urban Institute’s simulation model, it highlights financial disparities by age, income, and care intensity, emphasizing the need for targeted policy solutions. The final presentation examines caregiving-related job disruptions and cognitive outcomes, analyzing how workforce disruptions linked to caregiving contribute to cognitive decline, with disparities evident across gender and racial/ethnic groups. This is a collaborative symposium between the Aging Workforce and Family Caregiving Interest Groups.

BackgroundHealthcare disparities often cause rural BIG 1 TBI patients to be transferred to a higher level of care due to a fear of clinical decline.MethodsWe conducted a retrospective cohort study from 2020 to 2022 that compared patients with the principal diagnosis of BIG1 TBI who were transferred from rural critical access facilities in the upper Midwest to a tertiary care center vs those who were admitted directly to the same tertiary care center. The primary outcomes were cost and mortality. Statistical significance in mortality rates and length of stay was determined using Pearson's Chi Squared and Kruskal-Wallis tests, with significance thresholds set at α = 0.05.Results62 BIG1 patients were examined in the study and 18 were excluded. Of the 44 patients studied, there were no deaths in either group, and length of stay was not significant (P = .36). Transferred patients also underwent more head CT scans when compared to directly admitted patients (mean 2.5 vs 2.1, P = .003). For in-network costs, the average cost of transferred patients was $13,956 and the average cost for direct admissions was $9216 (P = .0003). For out-of-network costs, the average cost of transferred patients was $20,041 and the average cost for direct admission was $13,789 (P = .02).ConclusionCompared to patients who are directly admitted, transfer patients have an increased cost of care while having no difference in clinical outcomes. Technological advances in telemedicine and protocolized care may assist with decreasing the cost while increasing efficiency of care for these patients.

Informal caregivers provide critical unpaid care while facing significant financial, emotional, and physical challenges. This study examined factors associated with subjective financial strain and objective financial impacts among informal caregivers of older adults in the United States. Using data from the "Caregiving in the U.S. 2020" with 1,333 informal caregivers who reported caring for an adult aged 50+. Findings indicate that providing assistance with a greater number of instrumental activities of daily living (IADLs) and seeking information about financial help are both significantly associated with increased odds of experiencing subjective financial strain and objective financial impacts. Findings underscore the need for targeted financial support for informal caregivers heavily involved in assisting with IADLs. Financial assistance programs should consider the additional costs associated with these tasks. Policies should ensure that informal caregivers receive adequate and timely support once they request assistance to mitigate both objective and subjective aspects of financial burden.

Background:Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), affects approximately 4.9 million individuals globally. Advanced therapies have significantly improved IBD management; however, maintenance doses commonly exceed labeled recommendations for optimal efficacy. This study aimed to estimate the financial impact of introducing Risankizumab (RISA) for CD and Upadacitinib (UPA) for UC treatment in Saudi Arabia (KSA), incorporating adjusted dosing practices rather than label doses alone.Methods:Cost-calculation model (CCM) was developed to estimate average monthly costs per patient, capturing complexities like induction, maintenance adjustments, discontinuation, switching, re-induction, and death. Data on adjusted dosing were collected via two expert interviews. The CCM compared scenarios “with” and “without” UPA for UC, and “with” and “without” RISA for CD, analyzing financial impacts over a 5-year horizon, from the payer’s perspective.Results:Adjusted UC treatment doses increased five-year costs by 22% compared to label doses. Introducing UPA with adjusted dosing resulted in a 6.7% higher cost versus scenarios without UPA, based on tender prices. For CD, adjusted dosing increased treatment costs by 24.5% compared to label doses. However, adding RISA with adjusted dosing slightly reduced the total drug cost by 0.35%.Conclusion:Expert interviews and detailed patient pathway modeling indicated substantial cost increases for UC and CD treatments in KSA when adjusted doses were considered. The introduction of UPA and RISA under adjusted dosing yielded minor financial differences, with potential implications for economic evaluations in other regions.

Abstract Introduction/Objective Urinalyses (UA) are frequently ordered to diagnose urinary tract infections (UTIs), but a positive UA may indicate asymptomatic bacteriuria as well as a true UTI. To help ensure that urine cultures are always completed for UAs that are suggestive of infection, many laboratories use reflex algorithms to facilitate automatic ordering of urine culture based on the biochemical and/or microscopic results. Currently, criteria for urinalysis with reflex to culture (UARC) vary significantly between institutions, with less stringent criteria having clinical, operational and financial impacts. Historically, the reflex criteria in our health system were: positive leukocyte esterase or positive nitrite or moderate or many bactria or > 10 WBC count. In August, 2023, our health system implemented a new evidence-based criteria for urine cultures: WBC count of > 10 cells (>5 for pediatric patients <24 months).The objective of this study was to assess the clinical, operational and financial impacts of the UARC criteria change. Methods/Case Report We conducted a retrospective cohort study using Electronic Health Record (EHR) data at a health system consisting of 3 hospitals, an outpatient lab and a freestanding Emergency Department comparing the pre-implementation period of 12/15/22 - 8/14/2023 to the post implementation period of 8/15/2023 - 4/15/2024. We assessed clinical impact by comparing: 1) the daily percentage of UA reflexed to culture, overall (from inpatient/ED/observations/ambulatory settings) and in the ambulatory setting only between the two periods using interrupted time-series 2) the median length of stay (inpatient/observation visits) 3) the rate of UTIs identified based on ICD-10 discharge diagnoses We assessed operational impact using interrupted time-series by comparing the diagnostic efficacy of the reflex criteria (daily proportion of urine cultures with >100,000 CFU/mL bacterial growth) before vs after the change in criteria. Finally, we assessed financial impact by comparing the effect of the change on the cost of urine cultures performed on hospitalized patients before vs. after the change in UARC criteria. Results Our results showed that the percentage of UA that reflexed to culture from UARC orders decreased by 37% (p < 0.001) for orders from all settings and 35% for orders ambulatory setting after the criteria change. The length of stay did not change significantly between the pre and post time periods. The percentage of daily UTI diagnosis decreased but this change was not significant after adjusting for temporal trend. The culture positive rate of all cultures reflexed from UARC increased by 26% (p < 0.001) after the change reflecting a more efficient testing operation. Furthermore, the UARC criteria change led to a 31% ($65,000) decrease in the cost associated with urine cultures on inpatient visits. Conclusion Our study demonstrated a favorable clinical, operational and financial impact of limiting the criteria for UARC. In using our resources wisely, this change freed up laboratory staff to focus on more meaningful laboratory tests and saved costs related to culture supplies and labor. The results also show that reflex testing offers convenience to clinicians improves standard of care, yet reflex criteria need to be evaluated periodically to endure clinical, operational and financial appropriateness. This study is a testament to the fact that the laboratory can successfully implement evidence-based diagnostic stewardship in collaboration with multidisciplinary stakeholders and extract, analyze and review the data to show the impact.

Abstract This article examines the transformative potential of Lime Calcined Clay Cement (LC3) as a sustainable alternative to traditional cement, with emphasis on its economic, environmental and financial implications. LC3 is composed of limestone and calcined clay as supplementary materials reducing clinker content in cement. It significantly reduces the carbon emissions associated with cement production while maintaining competitive performance levels. This study introduces a novel evaluation tool designed to assess the various impacts of LC3 by comparing three different technologies: retrofitted kiln, rotary calciner and flash calciner. The analysis also considers the effects of a carbon tax and the impact of LC3 on Carbon Capture, Utilization, and Storage (CCUS) operational costs. The research results indicate that LC3 leads to a substantial reduction in greenhouse gas emissions and cost savings through increased resource efficiency and reduced energy consumption during production. In addition, the paper assesses the financial viability of LC3 adoption for stakeholders, highlighting potential market advantages and investment opportunities. The results suggest that the integration of LC3 into the construction industry can significantly contribute to sustainable development goals by promoting greener building practices and reducing the ecological footprint of construction projects. This paper provides valuable insights for policy makers, industry practitioners and researchers, and highlights the importance of adopting innovative materials such as LC3 to address pressing environmental challenges while ensuring economic resilience. By taking advantage of the proposed assessment tool, stakeholders can make informed decisions that facilitate the transition to a more sustainable built environment.

Unnecessary transfers for hand surgery evaluation result in significant costs to patients and consume valuable resources at trauma centers. The financial ramifications of these transfers on the receiving institution is largely unknown. This study was constructed to determine the impact of nonindicated transfers at our level 1 trauma center. We reviewed the records of 505 patients transferred from another facility to our emergency department between 2018 and 2023. Demographics and transfer specific information were collected. The American Society for Surgery of the Hand ER Hand Care Committee transfer guidelines were used to stratify patients into necessary and unnecessary transfers. The direct and indirect costs and total reimbursement for each unnecessary transfer were reviewed to determine the net operating margin over the 5-year period. Three hundred and nine patients (61%) did not need an urgent transfer to a higher level of care. Patients transferred unnecessarily were more likely to be uninsured (23% vs 15%). Most of these patients were discharged from the emergency department (73%). The payer mix for this analysis was 27% commercial, 25% Medicare, 22% Medicaid, 12% self pay, and 14% other. The net operating margin over 5 years was -$2628. Commercial insurance accounted for most of the financial gains. The financial impact of unnecessary transfers to our tertiary referral center for hand surgery consultation is not significant. The added benefits of lowering costs to patients and improving the use of emergency care resources by mitigating these transfers likely outweighs any financial impacts that may be experienced by receiving institutions.

Comment on “Inclusive Wealth and <scp>ESG</scp> Practices: Financial Impacts in a Global Context”

BackgroundPrefilled syringes provide an opportunity to improve clinical safety and operational efficiency in hospital settings, especially amid mounting and ongoing challenges such as staff shortages, escalating drug costs, and increasing importance of safe medication administration. Despite these potential benefits, adoption remains limited. This study develops an economic model to assess the clinical and financial impacts of switching from conventional vial-and-syringe methods to prefilled syringes in United States (US) hospitals’ intensive care units (ICU).MethodsTo address the gap between the potential benefits of prefilled syringes and their limited adoption, an economic model was developed to help decision-makers make informed choices based on the clinical and financial impact of switching to prefilled syringes in US ICUs. The model used peer-reviewed literature and hospital practices around the most utilized dosages in a US hospital. To illustrate model utility, three hypothetical ICU cases were developed: administering 30 daily doses of atropine 1mg/10mL, epinephrine 1mg/10mL, and ephedrine 25mg/10mL. Sensitivity analyses were performed to test model robustness.ResultsSwitching to prefilled syringes resulted in annual cost savings of $729,912 for atropine, $786,502 for epinephrine, and $709,772 for ephedrine. The model estimated annual savings to be $696,551 due to fewer pADEs, along with savings of $53,411, $89,744 and $50,244 annually, due to unused drug wastage reduction for each drug, respectively. Hospital staff preparation time decreased by 255 hours for atropine, 285 for epinephrine and 227 hours for ephedrine per year. Sensitivity analyses confirmed the robustness of the model by varying drug wastage rates, with potential savings of up to $740,443, $795,894 and $724,757 for each drug, respectively, showing the model’s adaptability across different ICU scenarios.ConclusionThis model suggests prefilled syringes may help hospitals address pharmacy operational challenges by reducing preparation time, drug wastage, and pADEs. They offer a practical approach to support safer and more efficient medication delivery in clinical settings.

359 Background: Healthcare providers’ ability to successfully engage in patient-centered communication (PCC) and shared decision making (SDM) is critical for prioritizing patient values and needs given the diversity of cancer treatment options available. This study aims to examine the impact of PCC and SDM on urologic cancer patients’ perceived knowledge and preparedness in treatment decision-making. Methods: Participants in Cancer Support Community’s Cancer Experience Registry reported sociodemographic and clinical information, decision-making style (provider-led, patient-led, shared), knowledge about cancer treatment options and financial impact as well as preparedness to make treatment decisions (on 5-pt scale, dichotomized for analysis), and PCC (6-item PCC short form). We ran three logistic regression models adjusting for sociodemographic and clinical factors, with outcomes: (1) knowledge of treatment options, (2) knowledge of financial impact, (3) and preparedness for treatment decisions. Results are reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results: The sample included 254 U.S. adults (75% men; ages 24-90 [Mean = 68, SD = 11]) with urologic cancer (54% prostate, 29% bladder, 15% kidney, 2% testicular), 48% in remission, 24% localized, 20% metastatic; 3yr Median time since diagnosis; 85% non-Hispanic White, 58% held a Bachelor’s degree or higher, and 58% had income ≥$40K. Decision-making styles were 58% patient-led, 31% shared, and 12% HCP-led. 54% felt quite a bit or very much knowledgeable about treatment options, 34% about financial impacts, and 56% prepared for treatment decisions. PCC scores were negatively skewed, indicating strong communication; a median split (Mdn = 4) was used in regressions. Higher PCC significantly predicted greater knowledge of treatment options (OR = 1.74[1.02-2.95]) and financial impact (OR = 2.02[1.10-3.70]) as well as feeling prepared to make treatment decisions (OR = 2.86[1.62-5.03]), adjusting for controls. Further, SDM (OR = 5.63[1.98-16.06]) and patient-led decision-making (OR = 5.53[1.85-16.55]) predicted greater preparedness than HCP-led decisions. Conclusions: Among urologic cancer patients, more than half reported good treatment knowledge and treatment preparedness, while only a third felt well informed of financial impacts of treatment. PCC was high and predicted greater perceived knowledge about treatment and finances, even when accounting for key sociodemographic and clinical factors. Additionally, both PCC and SDM predicted feeling prepared to make treatment decisions. Findings suggest that PCC and SDM play a critical role in patient experiences and strengthening these approaches in clinical settings may help ensure that care is more aligned with patients’ values, preferences, and needs.