New resource helps employers navigate cancer care
How can employers maximize the quality of care and value of treatment their employees receive?
Employers can learn how to best support workers diagnosed with cancer using the Northeast Business Group on Health’s guide, “Delivering Value in Cancer Care: The Employer Perspective.”
“For employers, maximizing the value of cancer care spending and ensuring that employees receive high-quality care are top priorities,” the authors write. “But while these priorities are clear, the road map to achieving them is not.”
Related: Cancer tops list of high-cost insurance claims for self-insured employers
The 36-page guide is based on an employer survey, as well as a roundtable discussion and additional interviews with employers, health plans and care providers. Key considerations are listed to help employers better assess the ROI of cancer care benefits and programs, and the guide also details some “high-value initiatives” that employers have implemented to support workers and family members dealing with cancer.
Benefits and services to consider offering include screenings for early detection; second/expert opinions, including reimbursement for travel-related expenses if necessary; care navigation; high-quality networks and CoEs; behavioral healthcare and emotional support; palliative/supportive care; help for caregivers; flexible benefit offerings that help with disability needs, work accommodations, life logistics and financial considerations; appropriate access to clinical trials; benefits that enable access to generic and specialty drugs, including biosimilars.
“As important as what is included in the design of cancer care benefits, is what is not included, such as overly restrictive provisions that do not take into account an individual patient’s circumstances,” the authors write.
It’s also highly recommended to use navigation services to increase both access to and utilization of cancer care, according to the guide.
“Navigators are generally oncology nurses or social workers who work with patients and their families to help them find the right treatment and location of care, and can often link them to resources to meet needs such as psychosocial support, child care and transportation,” the authors write. “This model has been shown to reduce gaps in care, cut care costs and improve patient adherence to treatment plans.”
The guide also offers tips on how employers can provide their workers with additional “cancer-friendly benefits,” as well as integrated behavioral health and emotional support. Employers can also learn how to actively engage with stakeholders to support their employees using strategies such as the “Cancer Care Huddle.”
“Engaging directly with all these stakeholders can be a time-consuming undertaking, so consider ways to reach them through intermediaries as well,” the authors write. “For example, other employers may be reached through participation in a business coalition. Similarly, the patient voice may be obtained through interacting with patient advocacy organizations, which often participate in business coalition activities.”
When evaluating treatment programs, employers should ask health care providers for data on treatment quality and cost; drug costs and site-of-care implications; and outcomes, and provide that data to stakeholders. To potentially enhance ROI, employers should explore “value-based payment” options, such as “episodes of care” or “bundles” and “total cost of care.”
It’s also important to offer workers wellness programs that can potentially reduce the risk of cancer, including tobacco-free policies that support employees who wish to quit and workplace access to healthy foods and nutrition education.
“External recognition of cancer prevention programs can support organizations in communicating about — and getting credit for — implementing best practice programs,” the authors write. “One example of such an external program is the CEO Cancer Gold Standard” which “provides a framework for employers to create a healthier workplace by focusing on cancer risk reduction, early detection, access to clinical trials and high-quality care.”
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