Cancer is a devastating disease that, with early diagnosis and treatment, can be overcome. According to the Business Group’s 2020 Large Employers’ Health Care Strategy and Plan Design Survey, 74% of employers cited cancer as one of the three top conditions impacting their health care costs in 2019. Employers can play a valuable role in an employee’s cancer journey through providing access to evidence-based, equitable care, while mitigating costs and unnecessary waste in the process. Below are eight recommendations for ensuring that your employees are receiving quality, cost-effective care:
- 1 | Strive to establish reasonable out-of-pocket thresholds so that cost is not a barrier for patients to obtain medications, including maintenance and supportive care drugs.
- 2 | Incorporate evidence-based cancer treatment (in medical plans, pharmacy benefit management programs [PBM], specialty pharmacy plans, and other relevant programs), building on guidance from the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN).
- 3 | Encourage appropriate application of personalized medicine including genomics.
- 4 | Consider steerage to specialized cancer centers for complex cases. According to the Business Group’s 2020 Large Employers’ Health Care Strategy and Plan Design Survey, 26% employers cited expanding centers of excellence to include additional conditions such as cancer as their top priority in addressing high cost claimants.
- 5 | Explore adopting oncology payment models developed by your carriers or providers that may incentive effective use of care utilization and adopt bundled payments for more routine cancer treatments.
- 6 | Encourage members to seek second opinion and use navigation services, if available.
- 7 | Promote and incentivize timely prevention screenings.
- 8 | Consider first dollar coverage for additional preventive testing, such as more frequent mammograms if recommended based on prior health history.
Learn more on how employers approach World Cancer Day. Visit the United Nations website for the full listing of UN-sponsored observances.
