I talk with benefits consultants every day, and increasingly one topic is always at the forefront: cancer, and what they should do differently in 2026.
And almost as often, I hear the reflexive pushback.
“My client already offers cancer benefits. Why do they need more?” “With other major cost drivers like GLP-1s and specialty drugs exploding, why should cancer be the priority, it’s always going to be a top area of spend?” Or, “where do I start with a cancer strategy anyway?”
Here’s the truth: Framing cancer as competing with other cost drivers is a false tradeoff, and it’s costing employers financially, culturally and clinically.
Yes, roughly 90% of employers already offer, or are planning to offer, some form of cancer benefit. But offering “something” is not a strategy. And it certainly is not the standard of care.
The first recommendation — the diagnostic interpretation, the treatment plan, the sequencing — reverberates through the entire journey. It shapes cost, clinical outcomes, and the employee’s confidence in their employer.
Employers need to ask: Are the benefits aligned with today’s evidence? Are we managing risk that comes from the good of innovation? Do we support employees across the entire cancer journey, not just at diagnosis? Do we deliver subspecialist-level expertise when it matters most? And can we measure, with certainty and claims data, that the benefit is working and improving care?
For most organizations, the answer is no. The consequences create risk for benefits leaders.
Cancer prevalence is rising, especially among working-age populations. Costs are climbing. And a single diagnosis not only impacts the individual facing cancer. It spreads across the organization. But it’s not just financial; a cancer diagnosis can destabilize the entire team with emotional strain and disrupted productivity.
Cancer care has moved from a niche concern to a strategic workforce reality. It’s about leadership, culture, and risk-management.
When an employee is diagnosed, the organization’s response becomes a referendum on its values. Do people feel supported? Do they trust their employer? And, do they believe they’d be cared for in their own moment of crisis?
Cancer exposes whether an employer’s benefits are built for real life, or just for open enrollment slides.
And consultants are the ones employers look to for clarity.
Cancer care innovation is evolving, with new, more effective therapies being introduced every year. But, employer benefits programs often struggle to keep pace with these changes. As a result, employees are not always assured access to the latest standard of care.
Evidence-based care is not a pamphlet, a navigation app or a collection of disconnected services. It is care grounded in the latest evidence, evolving research and coordinated clinical expertise.
Achieving this level of care requires targeted investment at multiple points in the cancer journey:
Viewed in isolation, these interventions may appear incremental. An advanced diagnostic test here. A treatment adjustment later. Enhanced symptom management along the way.
But when applied consistently across the full care continuum and across the covered population, the impact is outsized. Working in concert, they prevent ineffective or misaligned treatment. They reduce complications and avoidable acute care. They improve both outcomes and experience.
That is what true evidence-based care looks like.
And it is most consistently delivered where multidisciplinary review and subspecialization are routine, such as at National Cancer Institute-designated Comprehensive Cancer Centers.
Yet most employees never receive care that meets this level of rigor. Not because employers do not care, but because they do not realize what is missing.
There are only 57 NCI-designated Comprehensive Cancer Centers in 37 states. Most employees will never step foot in one or benefit from their expertise. Treatment at these centers can be challenging for patients who face socioeconomic and geographic barriers, since the complexities of travel and time can limit their access.
Roughly 80% of cancer care occurs in community settings. Community oncologists deliver essential, compassionate care. But they are navigating an unprecedented volume of new treatments, evolving guidelines, and rapidly expanding biomarker science. Subspecialization at the level of national centers is simply difficult within the traditional community model.
Without structured access to subspecialist insight and multidisciplinary review, variation in care is inevitable. Variation in care leads to variation in outcomes. And, variation in outcomes leads to unpredictable and escalating spend.
This is the part of the cancer conversation most employers never hear, but may matter most. In 2026 assessing risk is the key skill set.
Cancer is the highest-cost condition employers face. It’s also the most variable. When early decisions are misaligned with the standard of care, costs escalate through:
This is why expert second opinions should not be optional. They should be part of the very foundation of cancer care. Second opinions are not about replacing community oncologists. They are about empowering them. These expert second opinions can:
If consultants want to deliver a cancer strategy that actually works, this is where it begins.
A provider-empowered approach ensures treating physicians have structured access to subspecialist expertise, multidisciplinary review and evidence-based validation. It strengthens care decisions without disrupting care delivery.
When physicians are supported, patients benefit. And employers see the downstream effect in reduced variation and more predictable cost trajectories.
If you are going to spend millions of dollars on cancer care, shouldn’t you ensure those dollars are being spent appropriately? That is what it boils down to.
In my years working with consultants, I have never seen a benefits climate this complex. And cancer has never been more consequential.
Consultants have a choice: stick with the status quo, or raise the bar. Raising the bar is not about adding more point solutions. It is about providing clarity and helping employers understand what the standard of care in cancer actually requires.
But this is not just a consultant issue.
CHROs, total rewards leaders, and HR teams must also ask themselves:
Cancer is no longer a niche benefits issue. It is a litmus test of whether an organization truly supports its people through life’s hardest moments.
Doing nothing different is not neutral. It is a decision.
Your clients do not need more cancer programs per se. They need confidence that their employees are receiving care aligned with today’s standards. It’s as simple as that.
Expert second opinions are one of the most practical, scalable ways to deliver that confidence. If they are not part of the conversation, the strategy is incomplete.
What’s the cancer conversation you’re having with clients today? And where do you feel your clients are most unprepared in their cancer benefits strategies?