With new cancer fighting drugs emerging rapidly on the market, employers are faced with a new dilemma: How can they best support employees who have cancer while still managing the costs of their health plan? The new drugs offer better treatment outcomes, but the drugs themselves can be extremely costly, putting pressure on attempts to better manage plan expenses.
The Northeast Business Group on Health (NEBGH) devoted considerable resources in 2015 to study how employers with self-insured plans approach cancer treatment. Following workshops, interviews with plan managers, and a survey of about 20 self-insured employers, NEBGH said that employers clearly want individuals with cancer to have high quality treatment, but they have yet to develop a clear strategy for managing the cost of that treatment.
The small sample survey found that the majority of employers don’t have such products as a cancer-care buy-up package, which can help contain the often unpredictable costs of cancer treatment. Fewer than half have aligned their plan with a specific oncology network that is highly rated, although more than half include the services of an oncology center of excellence in their plan.
In general, this initial benchmarking survey indicated that the vast majority of employers offer good support services within their plans, including palliative care, extended hospice, cancer nutrition counseling, reconstructive surgery, and home health care.
Still, these plans often overlook relatively simple measures that could lead to better financial and medical outcomes.
Just more than half included coverage for second opinion services in their plans. The majority didn’t have a specific process for helping employees navigate their benefits plan to quickly learn what was available to them. More than half didn’t have an online portal where employees could access resources, and less than a third provided cancer-related training for managers and staff.
NEBGH said that employers should be working together more closely to identify centers of cancer treatment excellence and to benefit from group purchasing of cancer related services.
“Employers are invested in the well-being of their employees, and they want to be confident they’re steering people to trusted providers and institutions based on reliable information about outcomes and adherence to quality measures,” said Laurel Pickering, president and CEO of NEBGH. “Employers also have an important role to play by leveraging their purchasing power with health plans, hospitals and third parties to help accelerate greater transparency in quality, outcomes and pricing.”
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
