Large U.S. employers are shifting their employee benefits priorities for next year to control rising health care costs, which are expected to jump nearly 8% in 2025, according to a recent survey by the Business Group on Health. For the third year in a row, cancer is the top reported condition driving up health care costs and 72% of employers said they saw a higher prevalence of cancer among employees and their families.
Considering that early-onset cancer diagnoses in people under 50 increased globally by a staggering 79%, the employers' experience isn't surprising. Yet it will still challenge them to provide more robust cancer benefits to support employees through their entire care journey while also managing costs.
Cancer care requires a unique set of benefits that support employees and their families at every step, from genetic marker screening and early diagnosis to assistance with returning to the workplace. To offset the increased diagnoses and related costs, employers are investing in solutions to help people get screened and diagnosed earlier, connect with knowledge and guidance from leading cancer care centers, and better navigate the complexities of cancer care.
Here are five strategies to keep in mind when evaluating a cancer support program.
|1: Evaluate the expertise
When evaluating cancer support programs, it's essential to consider the depth of expertise they offer. Research shows that outcomes are better at National Cancer Institute (NCI)-Designated Comprehensive Cancer Centers, yet only 20% of cases are treated there.
For cancer, optimal care and treatment should always be the goal. However, cost-reduction efforts have led many plans to narrow their network options, often eliminating NCI 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 NCI centers are at the forefront of the latest evidence-based research and lifesaving discoveries, specialists at these facilities can help patients receive the most effective care. A study in the Annals of Surgical Oncology found that when cases are reviewed by a multidisciplinary tumor board at an NCI-Designated Comprehensive Cancer Center, it can lead to a change in diagnosis for up to 43% of patients.
Spend the time to analyze a program's clinical and financial impact and request evidence-based studies that demonstrate these benefits. When patients lack access to the right expertise and care for their specific cancer, employers can incur notably higher costs for treatments that aren't as effective. This is particularly true when the opportunity to potentially cure a patient is lost because they did not receive optimal treatment from the start.
|2: Break down barriers
When it comes to cancer support, access isn't a convenience, it's a lifeline. Employers should consider solutions that operate outside the traditional medical plan design, where potential barriers do not limit those who need specialized expertise and support.
Screening is critical but not enough on its own. With only 14% of cancers detected through routine screenings, access to regular check-ups becomes even more important. Unfortunately, high deductibles and coinsurance can create financial challenges, preventing people from seeking timely follow-up care and delaying early diagnosis after a positive screening result.
Although a second review can make a significant impact on the course of treatment, more than eight in 10 people who receive a cancer diagnosis don't seek a second opinion. Seeking treatment or a second opinion becomes more complicated when referrals are required.
Travel requirements for treatment or expertise can also pose challenges for people with cancer, especially those who are immunocompromised.
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