Controlling cancer benefits costs begins with internal decision-making

The CancerCare Employer Market Survey Findings Report shows that direct costs is the most important information source in benefits decision-making (98%).

When it comes to benefits decision-making, employers work best in teams. That’s according to the Gallaher Research & Insights, CancerCare Employer Market Survey Findings Report, which says the three stakeholders with the greatest influence are health benefits directors (58%), the vice-president of human resources (48%), and benefits consultants (46%). Overall, internal stakeholders have a greater influence than external.

Cost is also an important factor. The research shows that direct costs is the most important information source in benefits decision-making (98%). Employer organizational health care costs are more influential (94%) than any other factor when making health benefit decisions, including employee costs and issues. The second most influential factor is benefit consultant recommendations (74%). Rounding out the top five most important factors for benefits decision-making are employee population health data (66%), employer best practices (60%), and health plan recommendations (50%).

The report also looks at cancer care as a separate category. Most respondents (70%) say their cancer benefits coverage is on par with other peer companies, but only 10% of those surveyed say they carve out cancer care benefits from the overall benefits plan. For those that carve out cancer benefits, 100% of them say treatment navigation services are the most frequently offered benefit. Centers of Excellence is second at 60%, and second opinion services is tied at 60%.

Related: As cancer screenings decline, employers should take a better look at cancer benefits

When it comes to using Pharmacy Benefits Management (PBM), respondents are highly satisfied (82%) by the features their vendor offers. Respondents also think that utilization management (UM) tools can be very effective in controlling employees’ costs such as step therapy (81%), specialty pharmacy preferred drug list (71%), and formulary tiers (69%).

As for making those UM decisions, about 28% make the decisions themselves and take a more active approach. More than 50% look to advisors for expertise but require additional data to justify their recommended UM tools.