3 things employers don't know about cancer that will change their benefits package
Employers looking into cancer solutions should recognize the necessity of knowledge-sharing and collaboration between community medicine and academic medicine.
It’s no secret that cancer care is now the number one driver of an employer’s health care costs, accounting for 15% of spend. Given the notable increase in cancer in people under 50 and an anticipated rise in late-stage cancer diagnoses, employers should prepare to help more employees as they navigate their care journeys.
The growing volume of cancer cases and rising costs of care are understandably alarming. But there is a silver lining: advances in genomics and new targeted treatments can dramatically improve survival rates. The challenge lies in our ability to apply the latest cancer knowledge to address a nationwide expertise gap.
Cancer is one of the few areas of medicine where the gap between optimal care and typical care is actually widening. This means that patients often face over-, under-, and misutilization of care. However, by accessing targeted treatment specific to each patient’s unique situation earlier on in their journey the path to recovery can be much more effective and less costly.
HR leaders and benefits managers may not even realize that traditional ways of managing cancer care are holding them back from keeping up with the pace of change — and protecting employees starts with offering benefits packages that are built for today’s cancer reality.
Cancer care requires its own unique set of benefits
Cancer needs to be a primary focus when assessing what an optimal benefits package should include. Instead of focusing purely on costs, leaders must consider factors that might hinder their employees’ ability to receive effective and personalized cancer care — which will impact their quality of life and chances of survival.
Knowledge is power. Here are three important facts most employers don’t know about cancer that will help them build better benefits packages which may help improve outcomes, reduce wasteful spend, and address geography-based health disparities.
- Medical knowledge expands faster than oncologists can keep up
Medical knowledge used to double every 50 years, but it now doubles in just 73 days. This is especially true for the field of cancer considering that there are more than 100 types of cancers and more subtypes defined by site and genetic blueprint, and each cancer carries distinct and rapidly evolving targeted therapies and treatment paths.
Given the speed of latest advancements and best practices in testing and treatments, it can be challenging for oncologists to keep up, especially if they are treating different cancer types and dozens of patients every day. Oncologists need access to collective knowledge to stay up-to-date on emerging cures and treatment paths — and more complex cancer cases often require expertise from subspecialists.
Leading academic centers are a vital resource for accessing cancer subspecialists, but these may not be an option for many patients who simply live too far away or whose insurance plan does not cover services from these centers. Some health systems and cancer centers offer remote second opinions and there are now innovative cancer benefit solutions that provide remote expert case reviews from leading National Cancer Institute (NCI)-Designated Comprehensive Cancer Centers. Keep this in mind when building your benefits package.
- NCI-Designated Comprehensive Cancer Centers dramatically improve cancer outcomes and bridge expertise gaps
Research shows that NCI-Designated Comprehensive Cancer Centers dramatically improve cancer outcomes, yet only 20% of cases are treated there.
In an effort to reduce costs, many plans have narrowed their network options, often eliminating NCI-Designated Comprehensive Cancer Centers. While this may present perceived immediate cost savings, omitting access to expert subspecialists can drive higher costs with potentially suboptimal health outcomes. Given that these centers are at the forefront of the latest evidence-based research and lifesaving discoveries, NCI specialists can help patients receive the most effective care. A study in the Annals of Surgical Oncology found that a review by a multidisciplinary tumor board at an NCI-Designated Comprehensive Cancer Center can lead to a change in diagnosis for 43% of patients.
- Expert case reviews can identify more effective treatment options
Although a second review can make a significant impact on the course of treatment, more than eight in ten people who receive a cancer diagnosis don’t seek a second opinion.
A misdiagnosis means that a patient will fail to get the right care when they need it. The cost of treating relapsed, refractory, and metastatic cancers can far exceed the cost of delivering the best and most effective care from the beginning.
When patients lack access to the right expertise and care for their specific cancer, employers will incur notably higher costs. This is particularly true when the opportunity to potentially cure a patient is lost because they were misdiagnosed or received a less-effective treatment upfront. When it comes to cancer care, a second opinion can make a significant difference in treatment outcomes, including reduced toxicity and side effects from unnecessary treatments, and reduced long-term complications.
Building the right cancer benefit package starts with knowledge
Cancer is unlike other health conditions. One-size-fits-all solutions don’t work for cancer like they do for other chronic conditions — and benefit packages need to reflect that.
Related: Cancer vs. dental: Why we need to switch how they’re insured
Cancer knowledge is advancing faster than oncologists and benefits managers can keep up. Each cancer subspecialty carries its own treatment path considerations. Employers looking into cancer solutions should recognize the necessity of knowledge-sharing and collaboration between community medicine and academic medicine to identify partners that specialize in this field and help employees receive the latest insights and expertise while remaining under the care of their local oncologist.
Providing employees with access to high-quality oncology expertise and comprehensive support that overcomes geographic barriers will ensure optimal health outcomes, which is ultimately every employers’ goal.
Kathleen Frey, AccessHope VP of client excellence