Employers across the U.S. are preparing for open enrollment seasons that run November 1 through January 15, and cancer benefits are in the spotlight. The 2023 annual survey from the Business Group on Health found that cancer spending is a leading driver of healthcare expenditures and the survey highlighted the strategic initiatives undertaken by employers.
A recent article in Modern Healthcare explores how employers are shifting their cancer benefits strategies in the post-pandemic era. In an interview with AccessHope CEO Mark Stadler, the article outlines how employers are investing in virtual cancer care benefits as a covered medical benefit to help employees get diagnosed earlier, navigate the complexities of cancer care, and access support from specialists at NCI-Designated Comprehensive Cancer Centers.
Here are a few key reasons for the shift in focus on cancer benefits:
Rising costs of cancer care
Cancer continues to be a leading driver of healthcare expenditures surpassing musculoskeletal and cardiovascular conditions, accounting for 15% of health care spend and is likely to increase.
Much of the reason cancer is becoming increasingly expensive is related to the high costs of new targeted therapies and cancer drugs, representing 20% of total cancer care costs.
Rising prevalence of cancer in the workforce
Given the notable rise in cancer cases in people under 50 and increase of cancer survivors in the workforce, employers want to be prepared to help their employees throughout the entire cancer journey.
In the survey, 41% of employers are anticipating more late-stage cancers in their population due to delayed screenings. These more complex cases often require expertise of oncology subspecialists limited to leading academic centers.
Increasing adoption of specialized cancer care strategies
Employers want to ensure their employees are getting access to the right care and expertise at the right time. They are seeking cancer benefit solutions that improve the quality and value of cancer care for their employees while managing costs, as Stadler noted in the interview.
Among the strategies being considered are patient education, advanced screenings, virtual consultations, expert case reviews, specialty pharmacy drug management, and others. For example, patient education helps individuals understand their condition and treatment options, while remote expert case reviews provide convenient and timely access to a thorough review of medical records and treatment plan by a cancer subspecialist. Additionally, drug management platforms match employees with the most suitable and cost-effective oncology drugs, especially given the high cost and limited insurance coverage for some of these medications.
The survey found an overwhelming 53% of employers are set to introduce a cancer-focused center of excellence (COE) approach by 2024 to offer employees a personalized, multidisciplinary approach to their care (such as seeing more than just one doctor). These statistics indicate a growing momentum toward specialized cancer care strategies.
Removing geographic barriers to personalized cancer support and expertise
Large employers are challenged to address the diverse needs of their employees and geography can be a barrier to accessing the highest quality of care. Employees facing a cancer diagnosis have a much higher survival rate when they live closer to and are receiving treatment from oncologists at one of the country’s 56 NCI-Designated Comprehensive Cancer Centers. Yet, 80% of cancer patients are not treated at one of these centers.
As Stadler noted in the interview, many people cannot reasonably travel to these facilities which is why AccessHope’s relevance to employers continues to grow. Through remote expert case reviews, we ensure people with cancer and their treating oncologists benefit from the latest cancer research and innovations from these NCI-Designated Comprehensive Cancer Centers, no matter where they live.
As a result of the pandemic, there was a huge cultural shift to hybrid and remote working environments — and those related tech innovations have extended into healthcare: think about the rise of telehealth, for example. All of this is pointing employers toward a future with benefits and policies that are increasingly flexible, tech-driven, and personalized.